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目的分析庆阳地区耐碳青霉烯类抗生素鲍曼不动杆菌(CRAB)的分布特点及耐药情况,检测耐药表型,指导临床用药。方法常规培养分离细菌,应用VITEK 2 Compact全自动细菌分析仪鉴定细菌;用GN-AST09和K-B法检测细菌耐药性;通过改良Hodge试验和EDTA协同试验对碳青霉烯酶进行表型检测。结果 110株CRAB主要分离自痰液标本(70%),其次为肺泡灌洗液和伤口分泌物;科室分布以ICU比率最高(56%),其次为神经外科(20%),呼吸内科(9%)。在检测的12种药物中,对丁胺卡那、复方新诺明、左氧氟沙星敏感性较低,分别为33%、33%和7%,对其他抗生素耐药率均为100%;改良Hodge实验除1株为阴性外其他均为阳性;EDTA协同法实验均为阳性。结论 CRAB具有广泛的耐药性,应加强CRAB的耐药监测,建立有效的感染控制措施并合理应用抗菌药物,防止CRAB的流行。
Objective To analyze the distribution and resistance of carbapenem-resistant Acinetobacter baumannii (CRAB) in Qingyang area, detect the drug resistance phenotype and guide the clinical use of drugs. Methods Bacteria were isolated by routine culture and bacteria were identified by VITEK 2 Compact automatic bacterial analyzer. The drug resistance of bacteria was tested by GN-AST09 and K-B method. Phenotypes of carbapenemase were tested by modified Hodge test and EDTA synergistic test. Results The CRAB isolates were mainly isolated from sputum samples (70%), followed by alveolar lavage fluid and wound secretions. The distribution of ICU was the highest in ICU (56%), followed by neurosurgery (20%), respiratory medicine %). Of the 12 drugs tested, the sensitivity to amikacin, cotrimoxazole and levofloxacin was low, which were 33%, 33% and 7%, respectively, and the rates of resistance to other antibiotics were all 100%. The modified Hodge test Except 1 strain was negative, all others were positive; EDTA synergy test was positive. Conclusion CRAB has a wide range of drug resistance, should be strengthened CRAB drug resistance monitoring, the establishment of effective infection control measures and the rational use of antimicrobial agents to prevent the prevalence of CRAB.