鲍曼不动杆菌临床分布及NDM-1阳性菌的耐药性  

Distribution features of Acinetobacter baumannii and drug-resistance of NDM-1 positive strains

作　　者：王玮玮[1] 蓝惠华[1] 杨艳[1] 程玲[1] 金丹丹[1] 张玲[1] 王厚照[1] 

机构地区：[1]解放军174医院,福建厦门361003

出　　处：《职业与健康》2017年第10期1320-1323,共4页Occupation and Health

基　　金：全军医学科技创新项目(13QNP047);全军医学科技创新项目(14MS080);南京军区医学科技创新项目(2013ZD27)

摘　　要：目的分析厦门市某医院2014—2016年检出的鲍曼不动杆菌的分布特征和耐药性,筛选新德里·梅塔洛1号(NDM-1)阳性鲍曼不动杆菌,并对其进行耐药性检测。方法回顾性收集该院2014年1月—2016年6月检出的全部鲍曼不动杆菌资料,对其分布特征及耐药情况等进行汇总分析。用PCR法筛选NDM-1阳性鲍曼不动杆菌,探讨其耐药性现状。结果该院培养出鲍曼不动杆菌的标本来源主要为痰液、分泌物、尿液;鲍曼不动杆菌分离率在G-菌中所占比例较高,仅次于大肠埃希菌、肺炎克雷伯杆菌和铜绿假单胞菌,且2014—2016各年细菌分离率所占比例无较大变化;分离出鲍曼不动杆菌较多的科室主要为神经医学中心、呼吸内科、骨科等,在2014—2016年内变迁较小;19种抗菌药物2014—2016年耐药性变迁较大的有头孢曲松、亚胺培南、复方新诺明和四环素;实验中共筛出4株NDM-1阳性鲍曼不动杆菌,对选取的16种抗菌药物耐药情况显示对替加环素耐药性较低,而对头孢类抗生素、氨苄西林、呋喃妥因等耐药性较高。结论 2014—2016年该院鲍曼不动杆菌感染现状仍较为严峻,已成为医院感染的主要致病菌之一,且对不同抗菌药物耐药率在2014—2016年内有所差异。经检测该院鲍曼不动杆菌中存在NDM-1阳性菌,其耐药形势更为严峻。[Objective] To analyze the distribution features and drug-resistance of Acinetobacter baumannii strains isolated in a hospital of Xiamen City between 2014-2016. NDM-1 postive Acinetobacter baumannii strains were isolated for drug resistance test. [Methods] The data of Acinetobacter baumannii strains isolated from January 2014-July 2016 were collected in this hospital. Their distribution feature and drug resistance were analyzed. NDM-1 postive Acinetobacter baumannii strains were filtrated with PCR method,the drug-resistance was discussed. [Results] The main specimen source of Acinetobacter baumannii were from sputum, excretion, urine. The proportion of Acinetobacter baumannii in G-bacteria were relatively high, but next to E.coli, klebsiella pneumonia,pseudomonas aeruginosa, and the isolation proportion of bacteria did not significantly varied between 2014-2016. Acinetobacter baumannii were mainly collected from neuro medical center,respiration medicine and department of orthopaedics,with small variation between 2014-2016. While big transitions exited in ceftriaxone,imipenem,selectrin and aeheomyein among 19 antibacterial agents between 2014-2016. A total of 4 NDM-1 positive Acinetobacter baumannii were verified, showing a relatively lower resistance to tigecycline and a relatively higher resistance to cephalospora, ampicillin, and maerodantin. [Conclusion] The infection status of Aeinetobacter baumannii is still serious in this hospital from 2014-2016,and its resistance rate to different antibacterial agents has varied from 2014-2016. The test results show that NDM-1 postive strains exist,leading to a much serious drug-resistance condition.

关 键 词：鲍曼不动杆菌 分布特征 耐药性 NDM-1阳性 

分 类 号：R117[医药卫生—公共卫生与预防医学]