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[医院泛耐药鲍曼不动杆菌的耐药性分析]

[Drug resistance analysis of pan-drug-resistant Acinetobacter baumannii in hospital].

作者信息

Sun Cheng-dong, Li Zhen, Liu Si, Wang Yan

机构信息

Beijing Jishuitan Hospital, China.

出版信息

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013 Jun;25(6):369-72. doi: 10.3760/cma.j.issn.2095-4352.2013.06.013.

Abstract

OBJECTIVE

To investigate current situation of pan-drug-resistant Acinetobacter baumannii in hospital and its drug-resistance , then provide reference for rational use of antibiotics in clinic.

METHODS

All kinds of microbial test specimens from January 2009 to December 2012 of hospitalized patients were cultured and separated. VITEK 2-Compact fully automatic microorganism analyzer was used to identify and analyze drug sensitivity.

RESULTS

Three hundred and seven strains pan-drug-resistant Acinetobacter baumannii were isolated in 4 years, the primarily source were sputum, accounted for 69.4%, followed by the wound secretion 14.7%. The highest three places of samples separation of extensive drug-resistant Acinetobacter baumannii positive was intensive care unit (ICU, accounted for 26.4%), department of respiratory medicine (accounted for 26.1%) and department of geriatrics (accounted for 23.1%). Extensive drug-resistant Acinetobacter baumannii almost completely resisted to clinical commonly used antimicrobial agents, drug resistant rate could be as high as 100% such as cefotaxime, meropenem, piperacillin, imipenem, ciprofloxacin, and tetracycline except for cefoperazone-sulbactam and polymyxin, and the rate of other drugs were all above 90%. Drug-resistant of cefoperazone-sulbactam was nearly 30% in our hospital, and sensitive rate was 100% to polymyxin.

CONCLUSIONS

Pan-drug-resistant Acinetobacter baumannii is resistant for most clinical commonly used antimicrobial drug, antimicrobial agents were chosen according to drug susceptibility testing. Antibacterial drugs such as polymyxin and cefoperazone-sulbactam or sulbactam contained drugs can be selected for pan-drug-resistant.

摘要

目的

调查医院泛耐药鲍曼不动杆菌的现状及其耐药情况,为临床合理使用抗生素提供参考。

方法

对2009年1月至2012年12月住院患者的各类微生物检测标本进行培养分离。采用VITEK 2-Compact全自动微生物分析仪进行鉴定和药敏分析。

结果

4年共分离出307株泛耐药鲍曼不动杆菌,主要来源为痰液,占69.4%,其次为伤口分泌物,占14.7%。泛耐药鲍曼不动杆菌阳性标本分离率最高的三个科室为重症监护病房(ICU,占26.4%)、呼吸内科(占26.1%)和老年科(占23.1%)。泛耐药鲍曼不动杆菌几乎对临床常用抗菌药物完全耐药,除头孢哌酮-舒巴坦和多黏菌素外,头孢噻肟、美罗培南、哌拉西林、亚胺培南、环丙沙星和四环素等药物的耐药率可达100%,其他药物耐药率均在90%以上。我院头孢哌酮-舒巴坦耐药率近30%,对多黏菌素敏感率为100%。

结论

泛耐药鲍曼不动杆菌对多数临床常用抗菌药物耐药,应根据药敏试验选择抗菌药物。对于泛耐药菌可选用多黏菌素、头孢哌酮-舒巴坦或含舒巴坦的药物等抗菌药物。

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