CAJ | 학술논문

目的：了解基层医院 ICU 鲍曼不动杆菌（Acinetobacter baumannii ，Ab）的感染现状和评价《抗菌药物临床应用专项整治活动方案》的实施效果，为临床医生合理应用抗菌药物提供科学依据。方法用 VITEK2微生物分析系统对小榄医院2012年1月～2013年12月 ICU 患者标本中分离的鲍曼不动杆菌进行药敏分析，比较分析《抗菌药物临床应用专项整治活动方案》2012年（干预前）和2013年（干预后）ICU 鲍曼不动杆菌的耐药性。结果2012年（干预前）和2013年（干预后）从小榄医院 ICU 标本分离的鲍曼不动杆菌分别为71株和57株，其主要来源于呼吸系统感染，分别占94.4％和84.2％。该项方案干预后，多重耐药鲍曼不动杆菌的检出率由77.5％降为66.7％；鲍曼不动杆菌对头孢吡肟、头孢他啶、头孢曲松、妥布霉素和复方新诺明等的耐药率显著降低（χ2＞3.84，P ＜0.05）。结论该项方案干预后，ICU 患者标本分离的鲍曼不动杆菌对常用14种抗菌药物的耐药率低于干预前，其中有5种抗菌药物的耐药率显著降低。
목적：료해기층의원 ICU 포만불동간균（Acinetobacter baumannii ，Ab）적감염현상화평개《항균약물림상응용전항정치활동방안》적실시효과，위림상의생합리응용항균약물제공과학의거。방법용 VITEK2미생물분석계통대소람의원2012년1월～2013년12월 ICU 환자표본중분리적포만불동간균진행약민분석，비교분석《항균약물림상응용전항정치활동방안》2012년（간예전）화2013년（간예후）ICU 포만불동간균적내약성。결과2012년（간예전）화2013년（간예후）종소람의원 ICU 표본분리적포만불동간균분별위71주화57주，기주요래원우호흡계통감염，분별점94.4％화84.2％。해항방안간예후，다중내약포만불동간균적검출솔유77.5％강위66.7％；포만불동간균대두포필우、두포타정、두포곡송、타포매소화복방신낙명등적내약솔현저강저（χ2＞3.84，P ＜0.05）。결론해항방안간예후，ICU 환자표본분리적포만불동간균대상용14충항균약물적내약솔저우간예전，기중유5충항균약물적내약솔현저강저。
Objective To investigate the current situation on the infection of Acinetobacter baumannii in ICU and evaluate the efficiency of resistance control project which was performed in Xiaolan hospital,so as to provide scientific basis for clinical rational use of antibiotics.Methods Used VITEK-2 microbiology analysis system for the pathogen identification and drug sensitivity.Compared drug resistance of Acinetobacter baumannii isolated from the samples of ICU patients in 2012 (before the project executed)with that in 2013 (after the project executed).Results 71 strains and 57strains Acinetobacter bauman-nii were isolated from the ICU in 2012 (before the project executed)and in 2013 (after the project executed)respectively, which majorly isolated from the samples of respiratory system,and occupied 94.4% and 84.2% respectively.The infection rate of multi-resistant Acinetobacter baumannii was decreased from 77.5% to 66.7%,and the resistance rate of Acinetobact-er baumannii to cefepime,ceftazidime,cefatriaxone,tobramycin and cotrimoxazole decreased distinctly after the implementa-tion of drug resistance control management (χ2 > 3.84,P <0.05).Conclusion The drug resistance rates of Acinetobacter baumannii to 14 kinds of routine antibacterial drugs in 2013 were lower than that in 2012 in ICU.Among them,the drug re-sistance rates of Acinetobacter baumannii to 5 kinds of antibacterial drugs decreased distinctly.