耐亚胺培南鲍曼不动杆菌医院感染聚集性病例分析

摘要

Objective To explore the cause and drug resistance mechanism of nosocomial infection cluster cases(NICC) caused by imipenem‐resistant Acinetobacter baumannii(IRAB) .Methods The clinical data and the drug sensitivity test results of NICC caused by IRAB were analyzed .The disk diffusion (K‐B) method was adopted for conducting the drug susceptibility testing and the double disk diffusion assay for conducting the detection of metal beta‐lactamase (MBL) .Results NICC caused by IRAB occurred in May and once stayed in ICU ;among them ,7 cases were critical patients ,before occurrence of nosocomial infection ,9 cases had the history for using more than 3 kinds of antibacterial drugs ;the MBL detection was positive ;the clinically commonly used drugs for treating Acinetobacter baumannii infection were resistant .Conclusion The occurrence of NICC caused by IRAB is associated with the patient′ s susceptibility ,old age ,isolation and disinfection ,ward nosocomial infection surveillance ,use of antimicrobial drugs ,bi‐ological characteristics of AB ,and so on .The carbapenems‐resistant mechanism is the generation of MBL .%目的：探讨耐亚胺培南鲍曼不动杆菌（IRAB）引起医院感染聚集性病例（NICC）的原因及耐药机制。方法对IRAB 引起的 NICC 的临床资料、药敏结果进行分析。采用纸片扩散（K‐B）法进行药敏试验，双纸片增效法检测金属β内酰胺酶（MBL）。结果 IRAB NICC 均发生在5月，均曾入住过重症监护室（ICU）；其中危重患者7例，发生医院感染前，9例患者均有使用3种以上抗菌药物史。 MBL 检测均为阳性；对临床常用治疗 AB 的药物均耐药。结论 IRAB NICC 的发生与患者易感性、患有严重的基础疾病、高龄、隔离与消毒、病区医院感染监控、抗菌药物使用及 AB 的生物学特性等有关，碳青霉烯类耐药机制为产生了 MBL 。