摘要
目的:了解临床对鲍曼不动杆菌的抗菌药物选择及治疗效果,为临床合理用药提供依据。方法:2011-2012年,从某院临床标本分离86株鲍曼不动杆菌,经Vitek 2 Compact细菌仪鉴定,采用K-B纸片法进行药敏试验,分析抗菌药物选择及治疗效果。结果:86株鲍曼不动杆菌中,耐药品种数≤3的菌17株(19.8%),多重耐药菌49株(57.0%),泛耐药菌20株(23.3%);多黏菌素B敏感率为89.5%,其他12种抗菌药物敏感率均小于50%。临床选用抗菌药物共21种,单一用药59株,列前5位的药品分别为头孢他啶(23株)、亚胺培南(14株)、哌拉西林/他唑巴坦(10株)、头孢哌酮/舒巴坦(7株)、阿米卡星(5株);联合用药27株,选用药物为哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南分别与阿米卡星或左氧氟沙星联用。痊愈23例(26.7%),显效11例(12.8%),进步15例(17.4%),无效37例(43.0%),有效率为39.5%。结论:鲍曼不动杆菌耐药严重;对鲍曼不动杆菌感染患者临床应及时进行细菌培养和药敏试验后行目标治疗。
OBJECTIVE： To investigate therapy efficacy and selection of antibiotics against Acinetobacter baumannii, and to provide reference for rational use of antibiotics clinically. METHODS： 86 clinical isolates ofA. baumannii were identified by Vitek 2 Compact in a hospital from 2011 to 2012. K-B disc was used to test antibiotics susceptibility. Drug selection and therapy efficacy of antibiotics were compared before and after trial. RESULTS： Among 86 isolates ofA. baumannii, 17 isolates were resistant to less than 3 kinds of antibiotics （19.8%）; 49 isolates were multi-drug resistant （57.0%）;20 isolates are pan-drug resistant （23.3%）. The susceptible rate to polymyxin B was 89.5% and to other 12 types of antibiotics was less than 50%. A total of 21 kinds of anti- biotics were selected in the clinic. Single kind of antibiotics was selected for 59 isolates, among which top 5 drugs were ceftazi- dime （23 isolates）, imipenem （ 14 isolates）, piperacillin/tazobactam （ 10 isolates）, cefoperazone/sulbactam （7 isolates）, amikacin （5 isolates）. Piperacillin/tazobactam, cefoperazone/sulbactam, imipenem were combined respectively with amikacin or levofoxa/in for 27 isolates. There were 23 cured cases （26.7%）, 11 effective cases （12.8%）, 15 improved cases （17.4%）, 37 ineffective cas- es （43.0%）. Effective rate was 39.5%. CONCLUSIONS： The drug-resistance ofA. baumannii is very severe. The patients with A. baumannii infection should receive target treatment timely after bacterial culture and drug sensitivity test.
出处
《中国药房》
CAS
CSCD
2013年第42期3967-3968,共2页
China Pharmacy
基金
南昌市科技计划项目(No.[2009]171-14)
关键词
鲍曼不动杆菌
抗菌药物
药敏试验
多重耐药
Acinetobacter baumannii
Antibiotics
Drug-susceptibility test
Multi-drug resistance
