CAJ | 학술논문

目的研究2012~2013年我院多重耐药鲍曼不动杆菌(MDRAB)的感染分布特征及耐药性变化，为临床合理应用抗菌药物提供依据。方法采用法国梅里埃VITEK2/Compact全自动细菌培养鉴定仪进行细菌鉴定，采用纸片扩散法(K-B)进行药物敏感试验，药敏结果以CLSI2012版标准进行判读。结果2012年MDRAB检出率为25.8%，2013年检出率为16.08%，检出率略有下降但差异无统计学意义；2012年医院感染的MDRAB主要分布在呼吸内科(32.3%)、ICU(25.8%)和神经外科(16.1%)，2013年主要分布神经外科(39.1%)、ICU(17.4.0%)和呼吸内科(13.0%)，标本来源主要以痰液为主，分别为90.6%和91.3%。 MDRAB对常用25种抗菌药物的耐药率，除对粘菌素、米诺环素、头孢哌酮/舒巴坦的耐药率较低外，其余都在50%以上，对其中9种抗菌药物的耐药率为100%。结论通过我院对多重耐药菌医院感染的严格管理，2013年MDRAB检出率较2012年有下降趋势，大部分抗菌药物的耐药率也在下降。临床应继续重视MDRAB的感染，合理使用抗菌药物，加强消毒隔离，以更好地预防MDRAB的发生与播散。
목적연구2012~2013년아원다중내약포만불동간균(MDRAB)적감염분포특정급내약성변화，위림상합리응용항균약물제공의거。방법채용법국매리애VITEK2/Compact전자동세균배양감정의진행세균감정，채용지편확산법(K-B)진행약물민감시험，약민결과이CLSI2012판표준진행판독。결과2012년MDRAB검출솔위25.8%，2013년검출솔위16.08%，검출솔략유하강단차이무통계학의의；2012년의원감염적MDRAB주요분포재호흡내과(32.3%)、ICU(25.8%)화신경외과(16.1%)，2013년주요분포신경외과(39.1%)、ICU(17.4.0%)화호흡내과(13.0%)，표본래원주요이담액위주，분별위90.6%화91.3%。 MDRAB대상용25충항균약물적내약솔，제대점균소、미낙배소、두포고동/서파탄적내약솔교저외，기여도재50%이상，대기중9충항균약물적내약솔위100%。결론통과아원대다중내약균의원감염적엄격관리，2013년MDRAB검출솔교2012년유하강추세，대부분항균약물적내약솔야재하강。림상응계속중시MDRAB적감염，합리사용항균약물，가강소독격리，이경호지예방MDRAB적발생여파산。
Objective The changes of clinical distribution and drug resistance of multidrug resistant Acinetobacter baumanni (MDRAB)in the hospital in 2012~2013 were Studied in order to provide a foundation for rational administration of antimicrobial drugs.Methods The strain identification were performed by using VITEK-2 compact identification system and antimicrobial susceptibility testing were car ied out by means of Kirby-Bauer method.The data were analyzed by WHONET 5.6 software according to CLSI 2012 breakpoints.Results The detection rate of MDRAB was 25.83%in 2012,and 16.08%in 2013.The ratio declined slightly,with no statistical significance.MDRAB strains were mainly isolated from respiratory disease Department (32.3%/13.0),neurosurgical department (16.1%/39.1%)and neurosurgical intensive care unit(25.8%/17.4).The major specimens of MDRAB was sputum(90.6/91.3).MDRAB isolates showed the lowest resistant rates to Colistin,Minocycline and Cefoperazone/Sulbactam in the 25 kinds of commonly used antimicrobial drugs.The resistant rates of other antimicrobial agents were higher than 50.0%.The resistant rates to 9 kinds of drug resistance rate was 100%.Conclusion Through the strict management of multidrug resistant bacteria in hospital infection,the detection rate of MDRAB is decreased,the majority of antimicrobial resistance rates have dropped in.Clinical should continue to at ach importance to MDRAB infections,the rational use of antimicrobial drugs,to strengthen disinfection and isolation,in order to bet er prevent occur ence and spread of MDRAB.