2011-2014年某儿童医院多药耐药鲍曼不动杆菌临床分布及感染/定植情况分析  

Clinical distribution and infection / colonization of Acinetobacter baumannii in Children's Hospital,2011-2014

作　　者：温婵[1] 耿蓉娜[1] 赵博[2] 王敬铭[1] 孙立新[1] 冀迎春[1] 孙一硕 

机构地区：[1]河北省儿童医院,河北石家庄050031 [2]河北医科大学实验诊断教研室,河北石家庄050031

出　　处：《现代预防医学》2016年第5期936-938,960,共4页Modern Preventive Medicine

基　　金：河北省科技厅计划基金资助项目(132777142)

摘　　要：目的掌握2011-2014年全院多药耐药鲍曼不动杆菌临床分布特征及感染/定植状况,以减少多药耐药现象的发生。方法收集2011-2014年住院患儿标本,医院感染管理科专职人员,每日通过LIS系统,登记MDROs,汇总后分析鲍曼不动杆菌的标本来源、科室分布及感染特点。结果 2011-2014年共分离出多药耐药鲍曼不动杆菌373株,2011-2013年分离率大于70%,两两比较差异无统计学意义（P〉0.05）。2014年分离率为36.02%,明显下降（P〈0.05）。鲍曼不动杆菌主要分布在有ICU的科室,以重症科、心外科、普外科和新生儿科为主。占91.7%~98.6%以上。鲍曼不动杆菌的标本来源,主要是痰标本,占85.5%~91.9%。其他标本少见。鲍曼不动杆菌的感染部位构成比,下呼吸道感染占首位,构成比为83.6%,其次是呼吸机相关肺炎占6.4%。鲍曼不动杆菌感染主要来自于社区感染占67.0%,院内感染占26.0%,定植菌占7.0%。结论掌握多药耐药鲍曼不动杆菌临床分布规律,应加强耐药性监测,控制ICU等重点病房鲍曼不动杆菌的传播,有利于降低耐药菌检出率。Objective To investigate the clinical distribution and infection / colonization of MDROs of Acinetobacter baumannii in Hebei Children＇s Hospital from 2011 to 2014,so as to reduce the occurrence of multi- drug resistance. Methods Strains of Acinetobacter baumannii of children in hospital were collected from 2011 to 2014. The staff looked through the LIS system every day to find out MDROs. The specimen sources,distribution in departments and infection / colonization characteristics were statistically analyzed. Results Totally 373 strains of AB were detected. Separation rate from 2011 to 2013 was more than 70%. There was no significant difference（ P 〉0. 05）. Since our hospital carried out the regulation of antimicrobial drugs,the separation rate of 2014 was 36. 02%. There was a significant difference（ P 〈0. 05）. Acinetobacter baumannii were mainly distributed in the departments of severe care departments,cardiac surgery,general surgery and neonatology. Acinetobacter baumannii were mainly isolated from sputum. It was little in other samples. The main infection site of Acinetobacter baumannii was lower than respiratory tract. The constituent ratio was 83. 6%. Ventilator- associated pneumonia accounted for 6. 4%. The patients caused by community- acquired infection accounted for 67. 0%. Secondly by a hospital- acquired infection which was26. 0%,colonization accounted for 7%. Conclusion To understand the clinical distribution of AB was important. Monitoring should be enhanced,and strengthen the control of spread of ICU,so as to reduce the separation rate of AB.

关 键 词：鲍曼不动杆菌 多药耐药菌 儿童 感染 定植 

分 类 号：R115[医药卫生—公共卫生与预防医学]