血流感染鲍曼不动杆菌耐药性及流行病学研究  

Epidemiological characteristics and drug resistance of Acinetobacter baumannii in blood infection

作　　者：郭宁辉[1] 赵斌[2] 任微[3] 赵静[3] 褚美玲[3] 杨婧[4] 薛文成[3] 何莉[3] 

机构地区：[1]辽宁医学院沈阳军区总医院研究生培养基地,辽宁锦州121001 [2]南京军区总医院医务部,江苏南京210002 [3]沈阳军区总医院检验科,辽宁沈阳110840 [4]沈阳军区总医院感染控制科,辽宁沈阳110840

出　　处：《现代预防医学》2016年第5期769-772,共4页Modern Preventive Medicine

基　　金：辽宁省科技攻关计划(No.2011225021)

摘　　要：目的了解该院鲍曼不动杆菌(Acinetobacter baumannii,Aba)血流感染(Bloodstream infection,BSI)的临床分布特点及对抗菌药物的耐药性变迁,为指导临床合理选用抗菌药物及感染控制提供依据。方法回顾性分析2012年6月-2015年6月沈阳军区总医院各科室送检的血液标本的临床及微生物资料,根据药敏结果将其分为三组:非多重耐药性鲍曼不动杆菌(non-MDR-Aba)、多重耐药性鲍曼不动杆菌(MDR-Aba)、广泛耐药性鲍曼不动杆菌(XDR-Aba),统计病原菌科室分布、耐药性变迁及转归。采用SPSS 19.0进行统计学分析。结果 3年共收集87株Aba-BSI标本,XDR-Aba和MDR-Aba检出率最高的科室均为ICU(各占74.0%,50.0%)。87例Aba-BSI转归结局显示,死亡率为13.8%(12/87)。统计分析结果显示耐药表型与科室分布无统计学意义(=12.133,P=0.145),但与转归结局具有显著性差异(r=0.354,P<0.001),有统计学意义。结论 Aba-BSI最常见于ICU,且面临严峻的耐药形势,因此需要及时制定有效的感染控制政策,对鲍曼不动杆菌进行规范的、连续的耐药监测,控制鲍曼不动杆菌耐药的播散与流行。Objective To understand the distribution and drug resistance of A. baumannii in blood infection（ Aba- BSI）isolated from hospitalized patients,and to provide the reference for clinical rationale using antimicrobial agents and infection control. Methods The clinical data was reviewed retrospectively for 87 patients with a blood infection caused by A. baumannii who were treated in the General Hospital of Shenyang Military during June 2012 to June 2015. According to the results of the drug resistance,the isolated A. baumannii were divided into the following drug resistance categories： non- multi- drug resistance A. baumannii（ non- MDR- Aba）,multi- drug resistance A. baumannii（ MDR- Aba）,extensively drug resistant A. baumannii（ XDR- Aba）. The outcomes,the change of drug resistance and the distribution of pathogen were analyzed. All data was analyzed by SPSS 19. 0 software. Results A total of 87 specimens were collected from patients with Aba- BSI during3 years,the most frequently department isolated XDR- Aba and MDR- Aba was ICU（ 74. 0%,50. 0%,respectively）.Outcomes of 87 specimens with Aba- BSI showed that the mortality rate was 13. 8%（ 12 /87）. There was no statistical difference between the resistance phenotype and distribution of departments（ = 12. 133,P = 0. 145） while the differences between the resistance phenotype and the outcomes（ r = 0. 354,P〈 0. 001） were significant. Conclusion The Aba- BSI is most common in ICU and with the severe situation of drug resistance. It is of great necessity and importance to reinforce the infection control strategies,to strengthen the monitoring of drug resistance,and to prevent the spread of the resistance of A.baumannii.

关 键 词：血流感染 鲍曼不动杆菌 耐药性 流行病学 

分 类 号：R181.23[医药卫生—流行病学]