长期住院老年患者感染的鲍曼不动杆菌耐药性分析  

Drug resistance of Acinetobacter baumannii isolated from longterm hospitalized elderly patients

作　　者：赵付菊[1] 方毅[1] 刘华勇[2] 周丽芳[1] 庞立峰[1] 刘文健[1] 赵虎[1] 

机构地区：[1]复旦大学附属华东医院检验科,上海200040 [2]复旦大学基础医学院教育部/卫生部医学分子病毒学重点实验室,上海200032

出　　处：《微生物与感染》2014年第3期167-173,共7页Journal of Microbes and Infections

基　　金：中央保健委员会项目(B2009B042);上海市科学技术委员会项目(10ZR1410600)

摘　　要：为了解复旦大学附属华东医院长期住院老年患者感染的鲍曼不动杆菌的耐药性特征，本研究收集了2011年9月-2012年8月临床分离自老年病区长期住院患者的52株鲍曼不动杆菌，分析菌株的耐药性、产酶类型、生物膜形成能力及耐药基因的携带情况。结果显示，菌株主要分布在呼吸重症监护室，分离的标本以痰标本为主，占86．54％。52株鲍曼不动杆菌中，多重耐药菌株最高，占76．92％。对头孢哌酮／舒巴坦耐药率最低，为30．77％，对其余抗菌药物耐药率均在50％以上。产酶阳性率为82．69％，其中产其他水解酶的菌株最多，占63．46％。生物膜形成的检出率为5．77％。6株广泛耐药菌株共检出9种耐药基因。结果提示，从老年病区长期住院患者分离的鲍曼不动杆菌耐药现状严重。因此，医院感染控制应以呼吸重症监护室为重点，同时加强对生物膜阳性菌株所分布病区的耐药性监测和消毒隔离，以预防和控制耐药菌的产生和传播。To investigate the drug resistance of Acinetobacter baumannii （A. baumannii） isolated from long-term hospitalized elderly patients in our hospital, a total of 52 isolates collected between September 2011 to August 2012 were subjected to the enzyme production assay, biofilm-forming assay, drug resistance assay and screening of resistance genes. The main resource of the isolates was sputum specimens collected from patients in respiratory intensive care unit. The multidrug resistance rate of the collected strains was 76.92%, A. baumannii isolates showed the lowest resistance rate to cefoperazone-sulbactam, which was 30.77%. The resistance rates to other antimicrobial agents were over 50%. The positive rate of enzyme production was 82.69%, and the most common production was other hydrolytic enzymes （63.46%）. The biofilm-forming strains accounted for 5.77% of the isolates. 9 kinds of resistance genes were found in these 6 extensively drug-resistant strains. The study indicates that the grim situation of drug resistance of A.baumannii isolated from long-term hospitalized elderly patients. It is necessary to strengthen the monitoring of drug resistance, especially in respiratory intensive care unit. Meanwhile, drug resistance surveillance and disinfection and isolation should be strengthened in the endemic areas from where the biofilm-positive strains were isolated, so as to prevent and control the production and spread of multidrug-resistant and extensively drug-resistant bacteria.

关 键 词：鲍曼不动杆菌 耐药性 生物膜 医院感染 老年患者 

分 类 号：R446.5[医药卫生—诊断学]