ICU与非ICU科室鲍曼不动杆菌耐药性差异分析

摘要

目的 比较鲍曼不动杆菌(Acinetobacter baumannii,AB)在重症加强护理病房(intensive care unit,ICU)与非ICU科室的耐药性,为医院感染防控提供依据.方法 采用VITEK-2 COMPACT系统进行菌种鉴定,纸片扩散法进行药敏试验,医院感染实时监测预警系统统计耐药率.结果 (1)共检出病原微生物2797株,经培养分离出AB 385株,占13.76%,其中ICU 230株,非ICU科室155株.(2)AB主要来自于痰液(289株,占75.1%),以及脑脊液(22,5.7% )和分泌物标本(19,4.9%)等.(3)ICU的AB耐药株和泛耐药株检出比例高于非ICU科室,差异有统计学意义(χ2=8.863,P=0.003).(4)药敏结果示:ICU检出的AB菌株对亚胺培南、美洛培南、哌拉西林、阿米卡星等耐药率高于非ICU科室,差异有统计学意义(P<0.05).结论 ICU病房AB检出率、耐药性均高于非ICU病房,应加强其耐药性监测,合理使用抗菌药物,防止耐药AB医院感染的流行.%Objective To compare the drug resistance ofAcinetobacter baumannii (AB) between intensive care units(ICU) and non-ICU departments,in order to provide evidence for control of nosocomial infection.Methods All the isolated AB strains were identified by VITEK-2 COMPACT system.Antimicrobial susceptibility test were conducted by disc diffusion test,and drug resistance rates were calculated by nosocomial infection real-time monitoring and early warning system.Results (1) A total of 2797 pathogenic microorganism were detected,and 385 strains of AB were cultured and isolated,which made up 13.76% of total isolated sample.230 of which were isolated from ICU,and 155 from non-ICU departments.(2) Sputum was the main source where AB were isolated (289,75.1%),followed by cerebrospinal fluid (22,5.7%) and blood sample(19,4.9%),etc.(3) Drug resistant strains of AB were isolated higher in ICU than non-ICU departments,and the difference was statistically significant (χ2=8.863,P=0.003).(4) Drug sensitivity test results showed: strains of AB that isolated from ICU had higher drug resistance for imipenem,meropenem,piperacillin and amikacin than non-ICU departments,and the difference were statistically significant (P<0.05).Conclusions The isolation rate and drug resistance rate of AB in ICU is higher than that in non-ICU departments.Surveillance for drug resistance should be reinforced,and rational use of antimicrobial agents is critical to prevent the prevalence of drug resistant AB in nosocomial infection.