中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
12期
1816-1818
,共3页
亚胺培南%鲍曼不动杆菌%重症监护室%多重耐药
亞胺培南%鮑曼不動桿菌%重癥鑑護室%多重耐藥
아알배남%포만불동간균%중증감호실%다중내약
Imipenem%Acinetobacter baumannii%Intensive Care Unit%Multi drug resistance
目的 分析重症监护病房(ICU)的细菌分布及鲍曼不动杆菌的耐药性.方法 回顾性分析2009年1月至2013年9月内蒙古自治区人民医院ICU感染患者中分离出的1 079株菌株的病原菌分布和耐药性;细菌鉴定和药物敏感试验采用VITEK 2 Compact全自动细菌培养鉴定仪.结果 ICU患者中革兰阴性杆菌分离率为76.3% (823/1 079),其中鲍曼不动杆菌为29.2% (315/1 079),标本以痰液最多,为64.0%(691/1 079);耐亚胺培南鲍曼不动杆菌(IRAB)的检出率为91.7%(289/315).IRAB呈多重耐药,对复方磺胺甲u恶唑、妥布霉素、庆大霉素、左氧氟沙星、环丙沙星、氨苄西林舒巴坦、哌拉西林他唑巴坦、头孢他啶、头孢曲松、头孢吡肟和哌拉西林的耐药率分别为68.9%(199/289)、89.2%(257/289)、93.1% (269/289)、94.1%(272/289)、99.7%(288/289)、98.6%(285/289)、98.6% (285/289)、99.3%(287/289)、99.3%(287/289)、99.7%(288/289)和100.0%(289/289),对阿米卡星耐药率较低,为22.9%(62/271).IRAB对上述12种抗菌药物的耐药率,除复方磺胺甲(噁)唑外,均明显高于非IRAB,差异均有统计学意义(均P<0.05).结论 鲍曼不动杆菌在ICU的检出率较高,IRAB的分离率和耐药性较高,应加强耐药性监测,合理选用抗菌药物,有效控制IRAB的感染及流行.
目的 分析重癥鑑護病房(ICU)的細菌分佈及鮑曼不動桿菌的耐藥性.方法 迴顧性分析2009年1月至2013年9月內矇古自治區人民醫院ICU感染患者中分離齣的1 079株菌株的病原菌分佈和耐藥性;細菌鑒定和藥物敏感試驗採用VITEK 2 Compact全自動細菌培養鑒定儀.結果 ICU患者中革蘭陰性桿菌分離率為76.3% (823/1 079),其中鮑曼不動桿菌為29.2% (315/1 079),標本以痰液最多,為64.0%(691/1 079);耐亞胺培南鮑曼不動桿菌(IRAB)的檢齣率為91.7%(289/315).IRAB呈多重耐藥,對複方磺胺甲u噁唑、妥佈黴素、慶大黴素、左氧氟沙星、環丙沙星、氨芐西林舒巴坦、哌拉西林他唑巴坦、頭孢他啶、頭孢麯鬆、頭孢吡肟和哌拉西林的耐藥率分彆為68.9%(199/289)、89.2%(257/289)、93.1% (269/289)、94.1%(272/289)、99.7%(288/289)、98.6%(285/289)、98.6% (285/289)、99.3%(287/289)、99.3%(287/289)、99.7%(288/289)和100.0%(289/289),對阿米卡星耐藥率較低,為22.9%(62/271).IRAB對上述12種抗菌藥物的耐藥率,除複方磺胺甲(噁)唑外,均明顯高于非IRAB,差異均有統計學意義(均P<0.05).結論 鮑曼不動桿菌在ICU的檢齣率較高,IRAB的分離率和耐藥性較高,應加彊耐藥性鑑測,閤理選用抗菌藥物,有效控製IRAB的感染及流行.
목적 분석중증감호병방(ICU)적세균분포급포만불동간균적내약성.방법 회고성분석2009년1월지2013년9월내몽고자치구인민의원ICU감염환자중분리출적1 079주균주적병원균분포화내약성;세균감정화약물민감시험채용VITEK 2 Compact전자동세균배양감정의.결과 ICU환자중혁란음성간균분리솔위76.3% (823/1 079),기중포만불동간균위29.2% (315/1 079),표본이담액최다,위64.0%(691/1 079);내아알배남포만불동간균(IRAB)적검출솔위91.7%(289/315).IRAB정다중내약,대복방광알갑u악서、타포매소、경대매소、좌양불사성、배병사성、안변서림서파탄、고랍서림타서파탄、두포타정、두포곡송、두포필우화고랍서림적내약솔분별위68.9%(199/289)、89.2%(257/289)、93.1% (269/289)、94.1%(272/289)、99.7%(288/289)、98.6%(285/289)、98.6% (285/289)、99.3%(287/289)、99.3%(287/289)、99.7%(288/289)화100.0%(289/289),대아미잡성내약솔교저,위22.9%(62/271).IRAB대상술12충항균약물적내약솔,제복방광알갑(오)서외,균명현고우비IRAB,차이균유통계학의의(균P<0.05).결론 포만불동간균재ICU적검출솔교고,IRAB적분리솔화내약성교고,응가강내약성감측,합리선용항균약물,유효공제IRAB적감염급류행.
Objective To analyze the bacteria distribution and resistance of Acinetobacter baumannii in Intensive Care Unit(ICU).Methods Infection distribution and drug resistance of l 079 strains of pathogenic bacteria of the patients in ICU were retrospectively analyzed from January 2009 to September 2013 ; the bacteria identification and drug sensitivity were tested by VITEK 2 Compact automatic bacteria identification instrument.Results Pathogenic bacteria isolated from ICU patients with Gram negative bacilli was 76.3%,(823/1 079),in which Acinetobacter baumannii was 29.2% (315/1 079).Most specimens was from sputum (64%,691/1 079) ; imipenem resistant Acinetobacter (Bauman IRAB) detection rate was 91.7% (289/315).IRAB shows multiple drug resistance; the resistant rates of the compound sulfamethoxazole,tobramycin and gentamicin,ofloxacin,ciprofloxacin,ampicillin/ sulbactam,and piperacillin/ Tazobactam,cephalosporin,ceftriaxone,cefepime and piperacillin were 68.9% (199/289),89.2% (257/289),93.1% (269/289)and 94.1% (272/289),99.7% (288/289) and 98.6% (285/289),98.6% (285/289) and 99.3% (287/289),99.3% (287/289) and 99.7% (288/289) and 100.0% (289/289) respectively.The resistant rate for amikacin was 22.9% (62/271).Except compound sulfamethoxazole,resistance to other 11 kinds of antimicrobial agents was evidently higher in IRAB than that to non-IRAB (P < 0.05).Conclusion The detection rate of Bauman Acinetobacter in ICU is high; the isolation rate and drug resistance of IRAB is high.