重庆市丰都县人民医院鲍曼不动杆菌的分布特点及耐药性分析

发布时间：2019-07-24 08:06

【摘要】：目的分析鲍曼不动杆菌的分布特点、耐药性,以及耐碳青霉烯鲍曼不动杆菌(CRAB)感染的危险因素。方法对2013年10月至2015年10月该院临床分离的235株鲍曼不动杆菌进行药敏试验,按照2013年美国临床实验室标准化协会(CLSI)标准进行判读,并进行回顾性分析。结果鲍曼不动杆菌检出最多的为重症监护室(ICU),占53.19%;检出鲍曼不动杆菌的标本以痰液标本为主,占89.36%;鲍曼不动杆菌的耐药率较高,其对亚胺培南、头孢吡肟、头孢他啶及哌拉西林/他唑巴坦的耐药率分别为70.33%、73.21%、75.12%和66.03%;CRAB对碳青霉烯类、头孢菌素类和青霉素类的耐药率均高达100.00%;对哌拉西林/他唑巴坦、氨苄西林/舒巴坦等β内酰胺类/酶抑制剂复方制剂的耐药率也超过90%;感染CRAB的危险因素主要有入住ICU、联用过抗菌药物及使用呼吸机(P0.05)。结论鲍曼不动杆菌对常用抗菌药物呈现不同的耐药性,临床应结合患者的临床表现、药敏试验结果及抗菌药药代动力学(PK)/药效动力学(PD)特点制订个体化的治疗方案,减少耐药菌株的产生。
[Abstract]:Objective to analyze the distribution characteristics, drug resistance and risk factors of (CRAB) infection of Acinetobacter baumannii. Methods from October 2013 to October 2015, 23 strains of Acinetobacter baumannii isolated from October 2013 to October 2015 were tested and interpreted according to the (CLSI) standard of the American Association for Standardization of Clinical Laboratories in 2013, and the results were analyzed retrospectively. the drug sensitivity test of Acinetobacter baumannii was carried out. Results the most detected rate of Acinetobacter baumannii was (ICU), in intensive care unit (53.19%), sputum samples (89.36%), Acinetobacter baumannii (70.33%), ceftazidime (70.21%), ceftazidime (75.12%) and tazobactam (66.03%), and the resistance rate of Acinetobacter baumannii to imipenem, cefepidime, ceftazidime and piperacillin / tazobactam was 70.33%, 73.21%, 75.12% and 66.03%, respectively. The resistance rate of CRAB to carbapenem, cephalosporins and penicillin was as high as 100.00%, and to piperacillin / tazobactam, ampicillin / sulbactam and other 尾-lactam / enzyme inhibitors were also more than 90%. The main risk factors of CRAB infection were staying in ICU, combined with antibiotics and using ventilator (P 0.05). Conclusion Acinetobacter baumannii has different resistance to common antibiotics. Individualized treatment plan should be worked out according to the clinical manifestations of patients, the results of drug sensitivity test and the characteristics of antimicrobial pharmacokinetics (competition) / pharmacokinetics (PD), so as to reduce the production of drug-resistant strains.
【作者单位】：重庆市丰都县人民医院药剂科;
【分类号】：R446.5

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