梁玉金?张莉

[摘要] 目的 研究临床分离的鲍曼不动杆菌对常用临床消毒剂抗药性研究。 方法 收集自本院2014年1月～2015年12月临床患者分离获得的病原菌株鲍曼不动杆菌菌株60株。根据本医院抗菌药谱：氨曲南、妥布霉素、复方新诺明、氨苄西林-舒巴坦、亚胺培南、左旋氧氟沙星、头孢他定、头孢吡肟、庆大霉素、环丙沙星、呋喃妥因、哌拉西林-他巴唑坦等抗生素耐药敏感程度，分为三组分，鲍曼不动杆菌敏感株、多重耐药不含碳青霉烯类耐药、多重耐药含碳青霉烯类耐药。采用营养肉汤稀释法（试管法）分别测定含氯消毒片、复合碘皮肤消毒液、醋酸氯已定的最低抑菌浓度（MIC）值。 结果 含氯消毒片对鲍曼不动杆菌敏感株、多重耐药不含碳青霉烯类耐药和多重耐药含碳青霉烯类耐药的MIC值分别为（940±258）、（958±247）、（957±292）mg/L，MIC范围均为500～1500mg/L；复合碘皮肤消毒液为（45±23）、（54±30）、（49±30）mg/L，MIC范围均为34～63mg/L；醋酸氯已定為（26±20）、（23±10）、（29±35）mg/L，MIC范围敏感株和多重耐药不含碳青霉烯类耐药均为8～63mg/L，多重耐药含碳青霉烯类耐药为8～125mg/L。结论 本院分离的鲍曼不动杆菌在抗菌药物敏感程度不同情况下，对常用的三种消毒剂抗药性不存在差异。但是，含氯消毒片对分离的鲍曼不动杆菌实际使用浓度和推荐使用浓度存在较大差异。

[关键词] 鲍曼不动杆菌；消毒剂；含氯消毒片；复合碘皮肤消毒液；醋酸氯已定；抗药性

[中图分类号] R378 [文献标识码] A [文章编号] 2095-0616（2017）10-232-04

Study on drug resistance of clinical isolates of acinetobacter baumannii to Bauman

LIANG Yujin ZHANG Li

Clinical Laboratory， Shunde District Hospital of traditional Chinese Medicine， Guangdong， Foshan 528300， China

[Abstract] Objective To study the drug resistance of clinical isolates of Acinetobacter baumannii to Bauman. Methods Clinical isolates of 60 strains of Acinetobacter strains isolated from Bauman in our hospital from January 2014 to December 2015 were selected. According to the antimicrobial spectrum sensitivity to antibiotic resistance， such as aztreonam， tobramycin， compound sulfamethoxazole， ampicillin sulbactam， imipenem， levofloxacin， ceftazidime， cefepime， gentamicin， ciprofloxacin， piperacillin， piperacillin and methimazole， they were divided into three groups. Bauman sensitive Acinetobacter baumannii， multi drug resistant carbapenem resistant， multi drug resistant carbapenem resistant. The minimum inhibitory concentration （MIC） values were determined by nutrient broth dilution method （tube method）. Results The MIC values of the resistance to antibiotics and the multi drug resistance of carbapenem resistant Acinetobacter baumannii were （940±258）， （958±247）， （957±292）mg/L， and MIC range was 500 - 1500mg/L. Compound iodine skin disinfectant solution was （45±23）， （54±30）， （mg/L±30） mg/L， MIC range was 34-63 mg/L. Chlorhexidine acetate has been determined to be （26±20）， （23±10）， （29±35）， MIC range sensitive strains and multi drug resistant carbapenem resistance were 8 - 63 mg/L， and Multi drug resistant carbapenem resistance was 8 - 125 mg/L. Conclusion There are no differences in the resistance of the three commonly used disinfectants to Bauman in our hospital. However， there is a great difference between the actual concentration and the recommended concentration of the isolated Acinetobacter baumannii by using the chlorine disinfection tablet in the separation of Bauman.

[Key words] Acinetobacter Bauman； Disinfectant； Chlorine disinfection tablet； Compound iodine skin disinfectant； Chlorhexidine acetate； Drug resistance

鲍曼不动杆菌普遍存在自然界中，由于该菌具有极强的环境适应能力和获得外源耐药基因的能力，因而在医院内极易造成播散流行。……