CAJ | 학술논문

目的：了解2013年某院感染鲍曼不动杆菌临床分布及耐药性情况，为临床合理应用抗菌药物提供依据。方法对2013年1月至12月临床送检的痰、血液和尿液等标本进行细菌培养、分离与鉴定并进行抗菌药物敏感试验。采用VITEK-2 Compact全自动微生物鉴定系统或API细菌鉴定板条进行菌种鉴定。采用纸片琼脂扩散法（Kirby-Bauer法，KB法）进行药敏试验。采用WHONET 5.6软件进行数据分析。结果2013年共分离1417株鲍曼不动杆菌，呼吸道标本中所占比例最高，达到86.4%。临床分布以外科最多（28.2%，399/1417），其次是老年科（25.7%，364/1417）与监护病房（24.1%，341/1417）。2013年该菌株对临床常用抗菌药物高度耐药，除了米诺环素与阿米卡星外，其他药物耐药率均在65%以上。碳青霉烯类药物亚胺培南、美洛培南耐药率高达80.7%和81.9%。结论鲍曼不动杆菌在本院耐药率较高，应加强抗菌药物的合理使用，并建立切实有效的感染控制措施，阻断多重耐药菌的传播。
목적：료해2013년모원감염포만불동간균림상분포급내약성정황，위림상합리응용항균약물제공의거。방법대2013년1월지12월림상송검적담、혈액화뇨액등표본진행세균배양、분리여감정병진행항균약물민감시험。채용VITEK-2 Compact전자동미생물감정계통혹API세균감정판조진행균충감정。채용지편경지확산법（Kirby-Bauer법，KB법）진행약민시험。채용WHONET 5.6연건진행수거분석。결과2013년공분리1417주포만불동간균，호흡도표본중소점비례최고，체도86.4%。림상분포이외과최다（28.2%，399/1417），기차시노년과（25.7%，364/1417）여감호병방（24.1%，341/1417）。2013년해균주대림상상용항균약물고도내약，제료미낙배소여아미잡성외，기타약물내약솔균재65%이상。탄청매희류약물아알배남、미락배남내약솔고체80.7%화81.9%。결론포만불동간균재본원내약솔교고，응가강항균약물적합리사용，병건립절실유효적감염공제조시，조단다중내약균적전파。
Objective To investigate the clinical distribution and drug resistance of Acinetobacter baumanni (A. baumannii) in 2013 and to provide basis of rational use of antibiotics for the clinical departments. Methods The bacteria were isolated from specimens by conventional bacterial culture, which were identiifed by the VITEK-2 Compact fully automatic microorganism analyzer or API bacterial identiifcation strip. Antimicrobial susceptibility test were carried out by the disc diffusion method (Kirby-Bauer method). Data analyses were performed by Whonet 5.6 software. Results A. baumannii ranked the highest proportion (86.4%, 1 224/1 417) in respiratory tract samples. The highest three places of samples separation of A. baumannii positive were surgical department (accounted for 28.2%), department of geriatrics (accounted for 25.7%) and intensive care unit (accounted for 26.4%). The clinical strains were highly resistant to commonly used antibiotics. Most resistance rates of A. baumannii were more than 65%, except minocycline and amikacin. The resistance rates against imipenem and meropenem were highly as 80.7%and 81.9%, respectively. Conclusions Drug-resistance of A. baumanniiin the hospital was relatively serious. Therefore, the interventional infection control measures should be strengthened to prevent the spread of multi-drug resistant microorganisms.