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目的了解医院感染鲍氏不动杆菌的临床分布特点与耐药性,为控制医院感染提供依据。方法收集2011-2013年医院感染实时监控系统,回顾性分析综合医院临床送检标本鲍氏不动杆菌检测结果及其耐药性;采用法国生物梅里埃公司VITKE-2Campact全自动细菌鉴定仪进行菌株鉴定,药敏试验采用K-B纸片琼脂扩散法,使用SPSS 17.0软件进行统计分析。结果 2011-2013年医院住院患者送检标本中检出病原菌25 758株,其中鲍氏不动杆菌2 543株,检出率为9.9%;标本主要来自重症监护病房、呼吸内科、神经内科;鲍氏不动杆菌送检标本分离率居首位的是痰液;临床分离2 543株鲍氏不动杆菌对哌拉西林/他唑巴坦、氨苄西林/舒巴坦、头孢他啶、头孢吡肟、头孢呋辛、头孢噻肟、头孢曲松、亚胺培南、四环素、环丙沙星耐药率>80.0%,对庆大霉素和阿米卡星的耐药率分别为79.5%和78.5%;只对少数抗菌药物,如氨苄西林、阿莫西林/克拉维酸、头孢唑林、氨曲南、呋喃妥因的耐药率<20.0%。结论综合医院分离鲍氏不动杆菌临床分布主要集中在重症监护病房,其耐药率较高,并且多数呈现广泛耐药,应重视鲍氏不动杆菌感染的预防和监测,并对其耐药机制做进一步研究。
Objective To understand the clinical characteristics and drug resistance of Acinetobacter baumannii in hospital and provide basis for controlling hospital infection. Methods The real-time monitoring system for nosocomial infections during 2011-2013 was collected. The results of clinical tests and drug resistance of A. baumannii in clinical samples were retrospectively analyzed. The strain VITKE-2Campact automatic bacterial analyzer was used in the study. Identification, drug sensitivity test using KB paper agar diffusion method, using SPSS 17.0 software for statistical analysis. Results From 2011 to 2013, 25 758 pathogenic bacteria were detected in hospitalized patients, including 2 543 Acinetobacter baumannii strains, the detection rate was 9.9%. The specimens mainly came from intensive care unit, respiratory medicine and neurology. Acinetobacter sentinel specimens of the highest separation rate of sputum; clinically isolated 2 543 Acinetobacter baumannii piperacillin / tazobactam, ampicillin / sulbactam, ceftazidime, cefepime, The rates of resistance to cefuroxime, cefotaxime, ceftriaxone, imipenem, tetracycline and ciprofloxacin were> 80.0%, and the rates of resistance to gentamicin and amikacin were 79.5% and 78.5%, respectively %; Only a small number of antimicrobial drugs, such as ampicillin, amoxicillin / clavulanic acid, cefazolin, aztreonam, nitrofurantoin resistance rate <20.0%. Conclusion The clinical isolates of Acinetobacter baumannii in general hospitals are mainly concentrated in the intensive care unit. The drug resistance rate is high and most of them are widely drug-resistant. Therefore, the prevention and monitoring of Acinetobacter baumannii infection should be emphasized and resistant to Acinetobacter baumannii Mechanism for further research.