泰州地区鲍曼不动杆菌院内感染流行病学调查及耐药性分析

发布时间：2018-03-17 19:38

  本文选题：鲍曼不动杆菌　切入点：流行病学　出处：《苏州大学》2007年硕士论文　论文类型：学位论文

【摘要】： 细菌的耐药性是普遍存在的，对于它的发展趋势，从细菌本身看，呈现单一耐药到多重耐药的趋势，从抗菌药物方面看，呈现低耐药率到高耐药率的趋势，且发展速度越来越快近年来。由于抗菌药物的广泛使用甚至过度使用，鲍曼不动杆菌的耐药性呈总体上升趋势，耐药株迅速增加，并出现了多重耐药株。为了解鲍曼不动杆菌的分布特点，耐药性变化和医院肺部感染危险因素，正确选用有效的抗菌药物，对泰州地区两家综合性医院一年来分离的鲍曼不动杆菌引起的院内感染及对13种抗菌药物的耐药性作回顾性分析。 目的： 了解泰州地区两家综合性医院鲍曼不动杆菌的分布特点和耐药变化，以指导临床抗生素的合理使用。了解鲍曼不动杆菌医院肺部感染危险因素。 方法： 收集了2006年1月-2006年12月从泰州地区2家医院临床标本中分离检出的116株鲍曼不动杆菌。用法国生物梅里埃公司生产的VITEK32细菌鉴定系统的G-杆菌鉴定卡(GNI卡)将细菌鉴定到种；采用其GNS药敏试验卡测定最低抑菌浓度(MIC)，进行抗生素敏感性试验；按照美国国家临床实验室标准化委员会(NCCLS)2005年版的标准判断结果，以敏感率、中介率、耐药率报告结果；用世界卫生组织细菌耐药性监测网提供的WHONET5.4软件进行数据统计分析。对鲍曼不动杆菌引发的医院鲍曼不动杆菌肺炎45例患者的感染情况进行调查，采用病例对照研究，了解医院鲍曼不动杆菌肺炎的危险因素。 结果： 1．泰州地区鲍曼不动杆菌医院感染率较高，为3.93‰，主要分部在ICU病房，脑外科，烧伤科，呼吸科，老年科，其中ICU病房，脑外科，烧伤科，最常见。ICU病房占感染数35.3％，脑外科为11.2％，烧伤科为19.0％；药敏结果显示除亚胺培南，头孢哌酮／舒巴坦外，对其它抗生素的耐药率基本在50％以上； 2．危险因素分别为病情、ICU、免疫抑制剂、气管切开／插管、抗生素使用种类。 结论： 1、泰州地区鲍曼不动杆菌已成为医院内感染和肺部感染的重要病原菌。 2、通过耐药性分析，我们发现泰州地区Ab耐药现象较严重，且存在多重耐药情况。本地区Ab对推荐的敏感药物碳青霉烯类耐药性偏高，应引起重视。 3、泰州地区不同医院环境、不同科室环境及不同的感染部位，鲍曼不动杆菌的细菌敏感性的分布和耐药菌株的流行情况不尽相同。鲍曼不动杆菌医院感染以肺部感染率为最高，，病房分布依次为ICU病房、脑外科、烧伤科、呼吸科。 4、鲍曼不动杆菌肺炎的相关危险因素的单因素分析显示，基础疾病、ICU、气管切开／插管、抗生素使用种类、免疫抑制剂等是引起鲍曼不动杆菌肺炎的主要因素。
[Abstract]:The drug resistance of bacteria is widespread. From the point of view of bacteria itself, there is a tendency of single drug resistance to multidrug resistance, and from the aspect of antibiotics, there is a trend of low drug resistance rate to high drug resistance rate. The drug resistance of Acinetobacter baumannii has been on the rise and the resistant strains have been increasing rapidly due to the widespread use or even overuse of antimicrobial agents in recent years. In order to understand the distribution characteristics of Acinetobacter baumannii, the change of drug resistance and the risk factors of nosocomial pulmonary infection, the effective antimicrobial agents were selected correctly. The nosocomial infection caused by Acinetobacter baumannii isolated from two general hospitals in Taizhou area during the past year and its resistance to 13 antimicrobial agents were analyzed retrospectively. Objective:. To understand the distribution characteristics and drug resistance of Acinetobacter baumannii in two general hospitals in Taizhou to guide the rational use of antibiotics and to understand the risk factors of nosocomial pulmonary infection of Acinetobacter baumannii. Methods:. A total of 116 strains of Acinetobacter baumannii isolated from clinical specimens of two hospitals in Taizhou from January 2006 to December 2006 were collected. Identification of bacteria into species; The GNS drug sensitivity test card was used to determine the minimum inhibitory concentration (MIC) and the antibiotic sensitivity test was carried out according to the results of the National Committee for Standardization of Clinical Laboratories (NCCLS) of 2005, and the results were reported by the sensitivity rate, intermediate rate and drug resistance rate. The data of 45 patients with Acinetobacter baumannii pneumonia caused by Acinetobacter baumannii were investigated by using WHONET5.4 software provided by the World Health Organization bacterial Resistance Surveillance Network. To understand the risk factors of Acinetobacter baumannii pneumonia in hospital. Results:. 1. The nosocomial infection rate of Acinetobacter baumannii in Taizhou area was 3.93 鈥

本文编号：1626201