神经外科ICU患者感染鲍氏不动杆菌的耐药性及危险因素分析

发布时间：2018-03-02 07:13

  本文关键词： 鲍氏不动杆菌 药敏试验 耐药性 危险因素　出处：《中华医院感染学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的观察神经外科ICU鲍氏不动杆菌感染情况,分析鲍氏不动杆菌的耐药性及危险因素,为临床治疗提供依据。方法选取2013年1月-2015年12月浙江省金华市中心医院神经外科ICU 995例住院患者为研究对象,其中101例鲍氏不动杆菌感染患者为感染组,101例未发生医院感染的患者为对照组;统计神经外科ICU鲍氏不动杆菌的感染情况、耐药性及抗菌药物的使用情况,对比两组患者的临床资料对鲍氏不动杆菌感染的危险因素进行分析。结果 995例住院患者中,鲍氏不动杆菌感染101例,感染率为10.2%;共分离出鲍氏不动杆菌164株;单纯鲍氏不动杆菌感染76例(75.2%),混合感染为25例(24.8%);多药耐药菌感染52例(51.5%),泛耐药菌感染35例(34.7%);鲍氏不动杆菌对庆大霉素、妥布霉素、头孢他啶、氨曲南、头孢呋辛、头孢噻肟、磺胺甲VA唑/甲氧苄啶、头孢哌酮等耐药率分别为91.5%、90.2%、88.4%、83.5%、80.5%、75.6%、72.6%、70.1%,对亚胺培南和美罗培南的敏感率分别为75.6%和73.8%;101例患者中使用1、2、3、4、5种及以上抗菌药物者分别为4、8、18、20、51例,分别占4.0%、7.9%、17.8%、19.8%、50.5%;鲍氏不动杆菌感染组白蛋白35g/L和GCS评分≤8分比例高于对照组(P0.05),感染组机械通气和头部引流管率均高于对照组;白蛋白水平、GCS评分和头部引流管为鲍氏不动杆菌感染的独立危险因素(P0.05)。结论神经外科ICU鲍氏不动杆菌感染率较高,鲍氏不动杆菌耐药性严重,白蛋白水平、GCS评分和头部引流管是鲍氏不动杆菌感染的独立危险因素。
[Abstract]:Objective to observe the infection of Acinetobacter baumannii ICU in neurosurgery, and to analyze the drug resistance and risk factors of Acinetobacter baumannii. Methods from January 2013 to December 2015, a total of 995 ICU patients in neurosurgery department of Jinhua Central Hospital of Zhejiang Province were selected as the study subjects. Among them, 101 patients with Acinetobacter baumannii infection were the control group, 101 patients with nosocomial infection were the control group, the infection of Acinetobacter baumannii in neurosurgery department, the drug resistance and the use of antimicrobial agents were counted. Results among 995 hospitalized patients, 101 patients were infected with Acinetobacter baumannii and the infection rate was 10.2.The results showed that 164 strains of Acinetobacter baumannii were isolated, and the risk factors of Acinetobacter baumannii infection were analyzed. There were 76 cases of Acinetobacter baumannii infection, 25 cases of mixed infection, 52 cases of multidrug resistant bacteria infection, and 35 cases of pan-resistant bacteria infection. Acinetobacter baumannii infected gentamicin, tobramycin, ceftazidime, aztreonam, cefuroxime, cefuroxime, cefuroxime, ceftazidime, aztreonam, cefuroxime, cefuxime. The drug resistance rates of sulfamethazol / trimethoprim and cefoperazone were 91.5 and 90.2and 88.4, 83.5%, 80.5% and 72.6% respectively. The sensitivity rates to imipenem and meropenem were 75.6% and 73.8101, respectively. The ratio of albumin 35g / L and GCS score 鈮，

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