CAJ | 학술논문

目的：统计分析大连医科大学附属第一医院鲍曼不动杆菌的临床分布及对常用抗菌药物的耐药性，并比较ICU病房与非ICU病房分离的鲍曼不动杆菌的耐药率差异。方法2013年1月至2014年3月共分离鲍曼不动杆菌801株，其中ICU病房519株，占64．79％；非ICU病房282株，占35．21％。标本主要来源于痰液、尿液、血液、胸腹水、脑脊液、伤口分泌物等。利用全自动细菌鉴定及药敏分析仪进行细菌鉴定及药敏测定，补充药敏试验采用K－B纸片扩散法。采用WHONET软件对鲍曼不动杆菌分布及耐药性进行分析。结果801株鲍曼不动杆菌对15种所测抗生素均具有较高耐药性，其中对米诺环素耐药率略低，为31．5％。 ICU病房来源鲍曼不动杆菌对每种抗生素的耐药率均显著高于非ICU病房，差异具有非常显著性意义。结论 ICU病房来源的鲍曼不动杆菌耐药率显著高于非ICU病房分离株，加强鲍曼不动杆菌的控制与监测，临床医师更应结合药敏试验结果合理使用抗菌药物以降低鲍曼不动杆菌的耐药率。
목적：통계분석대련의과대학부속제일의원포만불동간균적림상분포급대상용항균약물적내약성，병비교ICU병방여비ICU병방분리적포만불동간균적내약솔차이。방법2013년1월지2014년3월공분리포만불동간균801주，기중ICU병방519주，점64．79％；비ICU병방282주，점35．21％。표본주요래원우담액、뇨액、혈액、흉복수、뇌척액、상구분비물등。이용전자동세균감정급약민분석의진행세균감정급약민측정，보충약민시험채용K－B지편확산법。채용WHONET연건대포만불동간균분포급내약성진행분석。결과801주포만불동간균대15충소측항생소균구유교고내약성，기중대미낙배소내약솔략저，위31．5％。 ICU병방래원포만불동간균대매충항생소적내약솔균현저고우비ICU병방，차이구유비상현저성의의。결론 ICU병방래원적포만불동간균내약솔현저고우비ICU병방분리주，가강포만불동간균적공제여감측，림상의사경응결합약민시험결과합리사용항균약물이강저포만불동간균적내약솔。
Objective To analyze clinical distribution and antibiotic resistance of Acinetobacter baumannii in our hospital, and to compare resistance rates of A.baumannii isolated from ICU and non-ICU wards.Methods A total of 801 samples were A.baumannii positive from Jan 2013 to Mar 2014, 519 (64.79%) samples were from ICU, while 282 (35.21%) were from non-ICU wards.The clinical specimens mainly included sputum, urine, blood, Pleural and peritoneal effu-sions, cerebrospinal fluid, wound secretion and so on.Bacterial identification and antibiotics susceptibility test were per-formed by automated bacterial identification and susceptibility analyzers.And complementary drug susceptibility test was performed by K-B disc diffusion method.WHONET software was used to analyze clinical distribution and antibiotic resist-ance of A.baumannii.Results A.baumannii in all of 801 samples kept higher resistance to 15 antibiotics.The drug re-sistance rate to minocycline was relatively low (31.5%), The resistance rate to each antibiotic of A.baumannii isolated from ICU was significantly higher than those isolated from non-ICU wards.Conclusion We should pay more attention to monitor the infection of A.baumannii and control the increasing drug resistance rate.