中国感染与化疗杂志
中國感染與化療雜誌
중국감염여화료잡지
CHINESE JOURNAL OF INFECTION AND CHEMOTHERAPY
2015年
1期
60-62
,共3页
赵建平%张叶毛%武芳%周秀岚
趙建平%張葉毛%武芳%週秀嵐
조건평%장협모%무방%주수람
亚胺培南%鲍曼不动杆菌%神经科%多重耐药
亞胺培南%鮑曼不動桿菌%神經科%多重耐藥
아알배남%포만불동간균%신경과%다중내약
imipenem%Acinetobacter baumannii%neurology%multidrug resistance
目的：了解神经科病房鲍曼不动杆菌的分布及耐药性。方法回顾性分析2009年1月—2014年3月神经科病房分离出的269株鲍曼不动杆菌的分布和耐药性；细菌鉴定和药敏试验采用 VITEK 2 Compact 全自动细菌培养鉴定仪；数据采用WHONET 5．6软件进行统计分析，耐药率的比较采用χ2检验。结果神经内科分离鲍曼不动杆菌的数量高于神经外科和神经重症监护病房，标本来源主要为痰液（97．4％）；耐亚胺培南鲍曼不动杆菌（IRAB）的分离率为54．3％；鲍曼不动杆菌除对阿米卡星的耐药率较低（20．7％），对亚胺培南和哌拉西林-他唑巴坦的耐药率已高达54．3％和55．0％；IRAB 对甲氧苄啶-磺胺甲口恶唑的耐药率（72．6％）低于非 IRAB（89．4％），差异有统计学意义（P ＜0．05）；对其他抗菌药物的耐药率 IRAB 明显高于非IRAB，差异有统计学意义（P＜0．05）。结论神经科病房鲍曼不动杆菌和 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，有效控制多重耐药鲍曼不动杆菌的感染及流行。
目的：瞭解神經科病房鮑曼不動桿菌的分佈及耐藥性。方法迴顧性分析2009年1月—2014年3月神經科病房分離齣的269株鮑曼不動桿菌的分佈和耐藥性；細菌鑒定和藥敏試驗採用 VITEK 2 Compact 全自動細菌培養鑒定儀；數據採用WHONET 5．6軟件進行統計分析，耐藥率的比較採用χ2檢驗。結果神經內科分離鮑曼不動桿菌的數量高于神經外科和神經重癥鑑護病房，標本來源主要為痰液（97．4％）；耐亞胺培南鮑曼不動桿菌（IRAB）的分離率為54．3％；鮑曼不動桿菌除對阿米卡星的耐藥率較低（20．7％），對亞胺培南和哌拉西林-他唑巴坦的耐藥率已高達54．3％和55．0％；IRAB 對甲氧芐啶-磺胺甲口噁唑的耐藥率（72．6％）低于非 IRAB（89．4％），差異有統計學意義（P ＜0．05）；對其他抗菌藥物的耐藥率 IRAB 明顯高于非IRAB，差異有統計學意義（P＜0．05）。結論神經科病房鮑曼不動桿菌和 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，有效控製多重耐藥鮑曼不動桿菌的感染及流行。
목적：료해신경과병방포만불동간균적분포급내약성。방법회고성분석2009년1월—2014년3월신경과병방분리출적269주포만불동간균적분포화내약성；세균감정화약민시험채용 VITEK 2 Compact 전자동세균배양감정의；수거채용WHONET 5．6연건진행통계분석，내약솔적비교채용χ2검험。결과신경내과분리포만불동간균적수량고우신경외과화신경중증감호병방，표본래원주요위담액（97．4％）；내아알배남포만불동간균（IRAB）적분리솔위54．3％；포만불동간균제대아미잡성적내약솔교저（20．7％），대아알배남화고랍서림-타서파탄적내약솔이고체54．3％화55．0％；IRAB 대갑양변정-광알갑구악서적내약솔（72．6％）저우비 IRAB（89．4％），차이유통계학의의（P ＜0．05）；대기타항균약물적내약솔 IRAB 명현고우비IRAB，차이유통계학의의（P＜0．05）。결론신경과병방포만불동간균화 IRAB 적분리솔화내약성교고，응가강내약성감측，합리선용항균약물，유효공제다중내약포만불동간균적감염급류행。
Objective To examine the distribution and antibiotic resistance of the Acinetobacter baumannii strains isolated from Department of Neurology.Methods A retrospective review was conducted for the 269 strains of A.baumannii isolated during the period from January 2009 to March 2014.VITEK 2 Compact system was used for bacteria identification and antimicrobial susceptibility testing.The data were analyzed with WHONET 5.6 software and compared by Chi-square test.Results The prevalence of A.baumannii was higher in Department of Neurology than in Department of Neurosurgery or Neurology ICU. Majority (97.4%)of the A.baumannii strains were isolated from sputum.About 54.3% of the A.baumannii isolates were resistant to imipenem.Relatively lower percentage of the A.baumannii isolates were resistant to amikacin (20.7%),but as high as 54.3% and 55.0% of the strains were resistant to imipenem and piperacillin-tazobactam.More imipenem-non-resistant A.baumannii strains (89.4%)were resistant to trimethoprim-sulfamethoxazole than imipenem-resistant A.baumannii (72.6%)(P < 0.05). However,to the other antimicrobial agents tested,imipenem-resistant A.baumannii strains showed significantly higher resistance rate than imipenem-non-resistant A.baumannii strains (P< 0.05).Conclusions The prevalence of A.baumannii and imipenem-resistant A.baumannii is high in Department of Neurology.Further monitoring of antibiotic resistance and rational use of antimicrobial agents are helpful to effectively control the epidemic of multidrug-resistant A.baumannii.
