本文關(guān)鍵詞： 鮑氏不動(dòng)桿菌 藥敏試驗(yàn) 耐藥性 危險(xiǎn)因素　出處：《中華醫(yī)院感染學(xué)雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的觀察神經(jīng)外科ICU鮑氏不動(dòng)桿菌感染情況,分析鮑氏不動(dòng)桿菌的耐藥性及危險(xiǎn)因素,為臨床治療提供依據(jù)。方法選取2013年1月-2015年12月浙江省金華市中心醫(yī)院神經(jīng)外科ICU 995例住院患者為研究對(duì)象,其中101例鮑氏不動(dòng)桿菌感染患者為感染組,101例未發(fā)生醫(yī)院感染的患者為對(duì)照組;統(tǒng)計(jì)神經(jīng)外科ICU鮑氏不動(dòng)桿菌的感染情況、耐藥性及抗菌藥物的使用情況,對(duì)比兩組患者的臨床資料對(duì)鮑氏不動(dòng)桿菌感染的危險(xiǎn)因素進(jìn)行分析。結(jié)果 995例住院患者中,鮑氏不動(dòng)桿菌感染101例,感染率為10.2%;共分離出鮑氏不動(dòng)桿菌164株;單純鮑氏不動(dòng)桿菌感染76例(75.2%),混合感染為25例(24.8%);多藥耐藥菌感染52例(51.5%),泛耐藥菌感染35例(34.7%);鮑氏不動(dòng)桿菌對(duì)慶大霉素、妥布霉素、頭孢他啶、氨曲南、頭孢呋辛、頭孢噻肟、磺胺甲VA唑/甲氧芐啶、頭孢哌酮等耐藥率分別為91.5%、90.2%、88.4%、83.5%、80.5%、75.6%、72.6%、70.1%,對(duì)亞胺培南和美羅培南的敏感率分別為75.6%和73.8%;101例患者中使用1、2、3、4、5種及以上抗菌藥物者分別為4、8、18、20、51例,分別占4.0%、7.9%、17.8%、19.8%、50.5%;鮑氏不動(dòng)桿菌感染組白蛋白35g/L和GCS評(píng)分≤8分比例高于對(duì)照組(P0.05),感染組機(jī)械通氣和頭部引流管率均高于對(duì)照組;白蛋白水平、GCS評(píng)分和頭部引流管為鮑氏不動(dòng)桿菌感染的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論神經(jīng)外科ICU鮑氏不動(dòng)桿菌感染率較高,鮑氏不動(dòng)桿菌耐藥性嚴(yán)重,白蛋白水平、GCS評(píng)分和頭部引流管是鮑氏不動(dòng)桿菌感染的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to observe the infection of Acinetobacter baumannii ICU in neurosurgery, and to analyze the drug resistance and risk factors of Acinetobacter baumannii. Methods from January 2013 to December 2015, a total of 995 ICU patients in neurosurgery department of Jinhua Central Hospital of Zhejiang Province were selected as the study subjects. Among them, 101 patients with Acinetobacter baumannii infection were the control group, 101 patients with nosocomial infection were the control group, the infection of Acinetobacter baumannii in neurosurgery department, the drug resistance and the use of antimicrobial agents were counted. Results among 995 hospitalized patients, 101 patients were infected with Acinetobacter baumannii and the infection rate was 10.2.The results showed that 164 strains of Acinetobacter baumannii were isolated, and the risk factors of Acinetobacter baumannii infection were analyzed. There were 76 cases of Acinetobacter baumannii infection, 25 cases of mixed infection, 52 cases of multidrug resistant bacteria infection, and 35 cases of pan-resistant bacteria infection. Acinetobacter baumannii infected gentamicin, tobramycin, ceftazidime, aztreonam, cefuroxime, cefuroxime, cefuroxime, ceftazidime, aztreonam, cefuroxime, cefuxime. The drug resistance rates of sulfamethazol / trimethoprim and cefoperazone were 91.5 and 90.2and 88.4, 83.5%, 80.5% and 72.6% respectively. The sensitivity rates to imipenem and meropenem were 75.6% and 73.8101, respectively. The ratio of albumin 35g / L and GCS score 鈮，

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