摘要
目的探讨重症监护室(ICU)鲍曼不动杆菌的耐药性、感染相关因素及正确的护理干预措施。方法针对2008年1月至2011年5月ICU 112例患者感染鲍曼不动杆菌的情况进行回顾性分析。鉴定及药敏结果判断采用Microscar NC31复合板。结果 112株鲍曼不动杆菌对亚胺培南敏感率20.54%、阿米卡星3.57%、替卡西林/克拉维酸4.46%;氨曲南0.89%敏感、6.25%中度敏感;哌拉西林1.79%敏感,3.57%中度敏感;氨苄西林/舒巴坦4.46%敏感、5.36%中度敏感;左氧氟沙星13.39%中度敏感;对环丙沙星、庆大霉素、妥布霉素、头孢曲松、头孢吡肟、复方磺胺、头孢噻肟、头孢他啶均100%耐药。患者住ICU时间长、免疫功能低下、机械通气、动静脉导管留置、鼻胃管、尿管留置以及广谱抗菌药物的应用,为鲍曼不动杆菌感染的主要相关因素。结论医院内获得性鲍曼不动杆菌对多种抗菌药物的耐药性极高,且泛耐药率增加较快。临床应合理使用抗菌药物,以提高疗效和减缓耐药株的产生;同时加强医护人员医院感染知识学习,实施有效的消毒隔离措施,是减少鲍曼不动杆菌院内感染发生的有效措施。
Objective To explore antibiotic resistance spectrum, risk factors and relevant nursing strategies of Acinetobaeter baumannii in intensive care unit （ICU） patients with infections. Methods 112 patients infected with Acinetobaeter baumannii in ICU from January, 2008 to May, 2011 were retrospectively analyzed by means of Microscar NC31 to conduct drug sensitivity experi- ment. Results Among 112 strains of Acinetobaeter baumannii, the rate of drug-sensitivity with Imipenem （IMI） was 20.54%, Amikaein 3.57% ,and Ticarcillin/Clavulanic acid 4.46% ;the rate of drug-sensitivity was 0.89 %, and 6.25 % medium sensitivity; the rate of drug-sensitivity with Piperacillin was 1.79 % ,and 3.57 % medium sensitivity;the rate of drug-sensitivity with Ampicil- lin/Sulbactam was 4.46% ,and 5.36% medium sensitivity; 13.39 %medium sensitivity with Levofloxacin. The rate of drug-resist- ance against Ciprofloxacin, Gentamicin, Tobramycin, Ceftriaxone, Cefepime, Compound sulfamethoxazole, Cefotaxime and Ceftazi- dime were all 100%. The main causes of Acinetobaeter baumannii infection were staying long time in ICU, low immunity, and the application of mechanical ventilation, arterial or intravenous conduit, nasogastric tube, urinary catheter and broad spectrum antibiot- ics. Conclusion Hospital-acquired Acinetobacter baumannii in ICU had high drug-resistance against many antibiotics and the rate of pandrug-resistance increased very quickly. As a result,great importance of clinical appropriate use of antibiotics should be attached so as to improve curative effect and reduce the strains of drug resistance. Meanwhile, doctors and nurses should learn some knowl- edge related to infection and take effective aseptic isolation measures for reducing the infection with Acinetobaeter baumannii.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第30期3058-3060,共3页
Chongqing medicine
关键词
重症监护病房
鲍氏不动杆菌
感染因素
感染控制与护理对策
intensive care units
acinetobacter baumannii
infectious factors
infection control and nursing strategy
