临床鲍曼不动杆菌在新时期中的超级耐药机制演变探讨.docVIP

精品论文 参考文献 临床鲍曼不动杆菌在新时期中的超级耐药机制演变探讨 蔡勤辉 (广东省汕尾市海丰县彭湃纪念医院检验科 516400) 　　【摘要】鲍曼不动杆菌是目前引起院内感染的重要条件致病菌之一，严重影响患者的生命安全。鲍曼不动杆菌特殊的基因结构导致其对多种临床抗生素产生高度耐药性，使其感染时可供选择的药物受限，且临床疗效相对较差。因而，现阶段必须明确鲍曼不动杆菌产生耐药性的机制，选择合理有效的抗生素，并根据药敏结果调整治疗方案。鲍曼不动杆菌的耐药机制主要是耐药酶的产生、药物作用靶位的改变、药物“外排泵”的形成、外膜结构及蛋白数量的改变以及整合子的结构和基因改变。临床医师应当明确鲍曼不动杆菌对于各类药物产生耐药性的机制，及时掌握本地区的鲍曼不动杆菌流行特点及耐药性，合理应用抗生素，并注意对患者痰液实施复检，以控制耐药菌株的感染率。 　　【关键词】 鲍曼不动杆菌 耐药机制 演变探讨 　　【中图分类号】R446.5 【文献标识码】A 【文章编号】1672-5085（2014）09-0097-02 　　Clinical acinetobacter baumannii in the new era of super resistant mechanism of evolution 　　【Abstract 】 acinetobacter baumannii is currently one of the most important pathogens of nosocomial infection, serious influence patients life. Acinetobacter baumannii special genetic structure, leading to its high resistance for a variety of clinical antibiotics, the infection when limited selection of drugs, and clinical curative effect is relatively poor. Therefore, the present stage must be explicitly acinetobacter baumannii resistant mechanism, choose reasonable and effective antibiotics, and adjust the treatment according to the results of the drug susceptibility. Mechanism of drug resistance of acinetobacter baumannii mainly resistant enzyme production, the change of drug action, the formation of drug efflux pump , and the outer membrane protein structure and quantity change and integration of sub structures and genetic changes. Clinical doctors should clear acinetobacter baumannii for all kinds of drug resistant mechanism, timely grasp the region of acinetobacter baumannii epidemic characteristics and drug resistance, reasonable use of antibiotics, and the note in patients sputum, to control the infection rate of the drug resistant strains. 　　【 key words 】 acinetobacter baumannii Drug resistance mechanism Evolution to investigate 　　鲍曼不动杆菌是一类氧化酶阴性、动力阴性、不发酵糖类的革兰阴性杆菌，是医院感染病原菌最常见菌种之一，主要引起呼吸道感染、泌尿系感染，也可引发菌血症、手术部位感染、继发性脑膜炎、呼吸机相关性肺炎等，具有较高的死亡率[1]。目前，对于鲍曼不动杆菌的研究越来越深入，其