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目的分析ICU洋葱伯克霍尔德菌医院感染情况及耐药特点。方法选择2012年1月-2016年12月医院ICU洋葱伯克霍尔德菌感染患者318例为研究对象,分析不同年份洋葱伯克霍尔德菌感染率、标本来源及对常用抗菌药物的耐药率。结果 2012年-2016年入住ICU患者共6339例,其中318例发生洋葱伯克霍尔德菌感染,感染率为5.0%;近5年洋葱伯克霍尔德菌感染呈上升趋势,2016年感染率为7.0%,显著高于2012-2015年的3.3%,3.7%,4.3%,4.5%,差异有统计学意义(P<0.05);2012年-2016年ICU洋葱伯克霍尔德菌主要以痰液分离为主,占59.12%,显著高于血、腹水、尿、分泌物、脓液等其他标本,差异有统计学意义(P<0.05);2012年-2016年ICU洋葱伯克霍尔德菌感染患者原发病以呼吸系统疾病为主,占33.02%,显著高于恶性肿瘤及其他原发病,差异有统计学意义(P<0.05);药物敏感试验显示近年来洋葱伯克霍尔德菌耐药菌株逐渐增加,耐药率有上升的趋势,其中2016年其对阿米卡星、庆大霉素、氨苄西林、头孢曲松、头孢替坦、呋喃妥因的耐药率均>90%,对磺胺甲噁唑/甲氧芐啶的耐药率最低。结论重症监护室洋葱伯克霍尔德菌感染率逐年上升,耐药株也有上升的趋势,临床上应选择敏感药物及时给予治疗。
Objective To analyze the infection and drug resistance characteristics of Burkholderia cepacia in the ICU. Methods A total of 318 patients with Burkholderia cepacia infection in the hospital from January 2012 to December 2016 were selected as study objects. The incidence of Burkholderia cepacia infection in different years, the origin of samples and their resistance to commonly used antibiotics Drug rates. Results A total of 6339 ICU patients were admitted between 2012 and 2016, of which Burkholderia cepacia was infected in 318 cases and the infection rate was 5.0%. Burkholderia cepacia infection was on the rise in recent 5 years and was infected in 2016 The rate was 7.0%, which was significantly higher than 3.3%, 3.7%, 4.3% and 4.5% in 2012-2015, the difference was statistically significant (P <0.05); 2012-2016 Burkholderia cepacia (59.12%) was significantly higher than those in other samples such as blood, ascites, urine, secretions, pus and other samples (P <0.05); 2012-2016 ICU onion Burke The primary disease in patients with Alzheimer’s disease was respiratory diseases, accounting for 33.02%, which was significantly higher than that of malignant tumors and other primary diseases (P <0.05). The drug susceptibility test showed that in recent years, Clostridium perfringens resistant strains gradually increased, the drug resistance rate is on the rise, of which in 2016 its amikacin, gentamicin, ampicillin, ceftriaxone, cefotetan, nitrofurantoin resistance rates were > 90%, the lowest rate of resistance to sulfamethoxazole / trimethoprim. Conclusion The infection rate of Burkholderia cepacia in the Intensive Care Unit has been increasing year by year. The resistant strains also have a tendency to rise. Clinically, the sensitive drugs should be given in time.