急性脑卒中患者医院感染鲍氏不动杆菌耐药性探讨

摘要

Objective To understand the antimicrobial resistance of Acinetobacter baumannii (ABA)causing noso-comial infection in patients with acute cerebrovascular disease and provide the reference for use of antibiotics to control it.Methods The retrospective review was performed for the clinical data of patients with acute cerebrovascular disease from Jan.2013 to Dec.2015.268 cases were infection of ABA.Infected sites and resistance rates were analyzed statisti-cally.Susceptibility testing was carried out by K-B methods.The WHONET 5.6 software was used to adopt the data. Results The infection sites were mostly the respiratory tract and the Skin and soft tissue,accounting for 56.7% and 16.8%,respectively.The isolating rates of imipenem-resistant ABA arrived at 42.9%.ABA kept 100.0% of sensitivity against amikacin and polymyxin B.Antibiotics with less than 20.0% of resistance rate included cefoperazone/sulbactam and minocycline,while more than 80.0% of resistance rate were cefuroxime and sulfamethoxazole/trimethoprim.Con-clusion The antimicrobial resistance was increasingly on the rise.Resistance monitoring should be regarded as focus to curb the rising speed and magnitude of bacterial drug resistance and block the outbreak of hospital infection.%目的 了解急性脑卒中患者感染鲍氏不动杆菌(ABA)的耐药性特征,为临床医师控制感染提供选药依据.方法 调取2013年1月-2015年12月医院急性脑卒中患者的病历,其中合并ABA感染268例,逐项统计其感染部位及耐药率数据,药敏采用KB法,应用WHONET 5.6处理结果.结果 268株ABA感染部位以呼吸系统和皮肤软组织为主,分别占56.7%、16.8%;耐亚胺培南鲍氏不动杆菌检出率为42.9%;ABA敏感率100.0%的抗菌药物是阿米卡星、多粘菌素B,耐药率<20.0%的药物有头孢哌酮/舒巴坦、米诺环素,耐药率>80.0%的药物是头孢呋辛、磺胺甲噁唑/甲氧苄啶.结论 ABA的耐药性日渐上升,医院应重视耐药菌监测控制,遏制细菌耐药性上升的速度与幅度,阻断医院感染暴发流行.