中国感染控制杂志
中國感染控製雜誌
중국감염공제잡지
Chinese Journal of Infection Control
2015年
9期
626-628,632
,共4页
张鹏%区伟俊%周燕斌%黄炎明
張鵬%區偉俊%週燕斌%黃炎明
장붕%구위준%주연빈%황염명
鲍曼不动杆菌%肺炎%医院获得性肺炎%耐药%多重耐药菌%泛耐药菌%抗药性,微生物%抗菌药物
鮑曼不動桿菌%肺炎%醫院穫得性肺炎%耐藥%多重耐藥菌%汎耐藥菌%抗藥性,微生物%抗菌藥物
포만불동간균%폐염%의원획득성폐염%내약%다중내약균%범내약균%항약성,미생물%항균약물
Acinetobacter baumannii%pneumonia%hospital-acquired pneumonia%drug resistance%multidrug-resist-ant organism%extensively drug-resistant organism%drug resistance,microbial%antimicrobial agent
目的:研究医院获得性鲍曼不动杆菌(AB)肺炎的细菌耐药情况,以指导临床规范用药,降低耐药率。方法回顾性分析某院2009—2012年发生的医院获得性 AB 肺炎患者临床资料,采用统一的方案、方法和判断标准进行 AB 耐药性数据汇总和统计分析。结果共有284例医院获得性 AB 肺炎患者,主要分布于综合重症监护病房(ICU,45.07%)、呼吸科(19.01%)、神经外科(9.15%)、神经内科(5.99%)。医院获得性 AB 肺炎的感染发病率及多重耐药 AB(MDR-AB)、泛耐药 AB(XDR-AB)的感染发病率呈上升趋势。总体耐药率以头孢哌酮/舒巴坦(9.51%)和米诺环素(9.86%)较低,左氧氟沙星(43.66%)和环丙沙星(45.42%)较高;对亚胺培南的耐药率为16.20%,美罗培南为20.42%。AB 对美罗培南、亚胺培南、头孢哌酮/舒巴坦、氨苄西林/舒巴坦的耐药率呈逐年上升趋势,差异均有统计学意义(均 P <0.05)。结论 AB 耐药现象严重,应加强 AB 耐药性监测,防止医院内传播。
目的:研究醫院穫得性鮑曼不動桿菌(AB)肺炎的細菌耐藥情況,以指導臨床規範用藥,降低耐藥率。方法迴顧性分析某院2009—2012年髮生的醫院穫得性 AB 肺炎患者臨床資料,採用統一的方案、方法和判斷標準進行 AB 耐藥性數據彙總和統計分析。結果共有284例醫院穫得性 AB 肺炎患者,主要分佈于綜閤重癥鑑護病房(ICU,45.07%)、呼吸科(19.01%)、神經外科(9.15%)、神經內科(5.99%)。醫院穫得性 AB 肺炎的感染髮病率及多重耐藥 AB(MDR-AB)、汎耐藥 AB(XDR-AB)的感染髮病率呈上升趨勢。總體耐藥率以頭孢哌酮/舒巴坦(9.51%)和米諾環素(9.86%)較低,左氧氟沙星(43.66%)和環丙沙星(45.42%)較高;對亞胺培南的耐藥率為16.20%,美囉培南為20.42%。AB 對美囉培南、亞胺培南、頭孢哌酮/舒巴坦、氨芐西林/舒巴坦的耐藥率呈逐年上升趨勢,差異均有統計學意義(均 P <0.05)。結論 AB 耐藥現象嚴重,應加彊 AB 耐藥性鑑測,防止醫院內傳播。
목적:연구의원획득성포만불동간균(AB)폐염적세균내약정황,이지도림상규범용약,강저내약솔。방법회고성분석모원2009—2012년발생적의원획득성 AB 폐염환자림상자료,채용통일적방안、방법화판단표준진행 AB 내약성수거회총화통계분석。결과공유284례의원획득성 AB 폐염환자,주요분포우종합중증감호병방(ICU,45.07%)、호흡과(19.01%)、신경외과(9.15%)、신경내과(5.99%)。의원획득성 AB 폐염적감염발병솔급다중내약 AB(MDR-AB)、범내약 AB(XDR-AB)적감염발병솔정상승추세。총체내약솔이두포고동/서파탄(9.51%)화미낙배소(9.86%)교저,좌양불사성(43.66%)화배병사성(45.42%)교고;대아알배남적내약솔위16.20%,미라배남위20.42%。AB 대미라배남、아알배남、두포고동/서파탄、안변서림/서파탄적내약솔정축년상승추세,차이균유통계학의의(균 P <0.05)。결론 AB 내약현상엄중,응가강 AB 내약성감측,방지의원내전파。
Objective To investigate antimicrobial resistance of Acinetobacter baumannii (A.baumannii)causing hospital-acquired pneumonia (HAP),so as to guide rational use of antimicrobial agents and reduce antimicrobial re-sistant rate.Methods Clinical data of patients with A.baumannii HAP in a hospital between 2009 and 2012 were collected and analyzed retrospectively.Antimicrobial resistance data were summarized and analyzed statistically ac-cording to uniformed methods.Results A total of 284 patients developed A.baumannii HAP,patients mainly distributed in intensive care unit(45.07%),department of respiratory diseases(19.01%),neurosurgery (9.15%),and neurology (5.99%).The incidences of A.baumannii HAP,multidrug-resistant A.baumannii (MDR-AB)HAP,and extensively drug-resistant A.baumannii (XDR-AB)HAP increased year by year.The total resistant rates of A.baumannii to cef-operazone/sulbactam (9.51%)and minocycline(9.86%)were low,to levofloxacin(43.66%)and ciprofloxacin(45.42%) were relatively higher;resistant rates to imipenem and meropenem were 16.20%and 20.42% respectively.The resistant rates to meropenem,imipenem,cefoperazone/sulbactam,and ampicillin/sulbactam increased year by year (all P <0.05). Conclusion Antimicrobial resistance of A.baumannii is serious,it is essential to strengthen the monitoring of antimicrobial resistance of A.baumannii,and prevent the spread in hospital.