NICU鲍曼不动杆菌的医院感染与耐药性分析  

Healthcare-associated infection and drug resistance of Acinetobacter baumannii in neonatal intensive care units

作　　者：庄璐 章晟 宋婕 张玉佩 韦秀娟 夏娴 卢庆彬[3] 李秋平 封志纯 ZHUANG Lu;ZHANG Sheng;SONG Jie;ZHANG Yu pei;WEI Xiu juan;XIA Xian;LU Qing bin;LI Qiu ping;FENG Zhi chun(Ba Yi Children’s Hospital Affiliated to PLA Army General Hospital, Beijing 100700, China;PLA Army General Hospital, Beijing 100700, China;School of Public Health, Peking University, Beijing 100191, China)

机构地区：[1]陆军总医院附属八一儿童医院,北京100700 [2]陆军总医院,北京100700 [3]北京大学公共卫生学院,北京100191

出　　处：《中国感染控制杂志》2017年第11期1016-1020,共5页Chinese Journal of Infection Control

基　　金：国家自然科学基金(81170602);中国博士后科学基金(2013M542472)

摘　　要：目的了解新生儿重症监护病房(NICU)鲍曼不动杆菌的临床特征及耐药性。方法对2012年10月—2014年10月某院4个NICU鲍曼不动杆菌医院感染临床分离情况及耐药性进行回顾性分析。结果 4个NICU共收治新生儿11 640例,发生医院感染500例(4.3%),其中鲍曼不动杆菌医院感染51例(10.2%),52例次。鲍曼不动杆菌感染:极早产NICU42例次,早产NICU1例次,足月NICU4例次,儿童外科NICU5例次。4个季节鲍曼不动杆菌医院感染发病率比较,差异具有统计学意义(χ~2=16.05,P<0.05),主要发生在春、夏两季。鲍曼不动杆菌对哌拉西林/舒巴坦、头孢吡肟、亚胺培南等β-内酰胺类抗生素以及庆大霉素耐药率较高(>90%),对阿米卡星耐药率最低,也高达51.9%。52株鲍曼不动杆菌中,46株为多耐药菌株,3株为广泛耐药菌株。结论 NICU鲍曼不动杆菌医院感染最严重的是极早产NICU,对临床常用抗菌药物均呈现高耐药率。ObjectiveTo investigate the clinical characteristics and antimicrobial resistance of Acinetobacter baumannii(A.baumannii)in neonatal intensive care units(NICUs).MethodsThe clinical isolation and antimicrobial resistance of A.baumannii causing healthcare associated infection(HAI)in4NICUs of a hospital from October2012to October2014were analyzed statistically.Results A total of11640neonates were admitted in4NICUs,500(4.3%)developed HAI,51(10.2%)developed52cases of A.baumannii infection.Distribution of A.baumannii infection was as follows:NICU of extremely premature infants,premature infants,full term infants,and surgical NICU were42,1,4,and5cases respectively.Incidences of A.baumannii HAI in4seasons were compared,difference was statistically significant(χ2=16.05,P<0.05),infection mainly occurred in the spring and summer.A.baumannii had high resistance rates toβlactam antibiotics(such as piperacillin/sulbactam,cefepime,imipenem)and gentamycin(>90%),resistance rate to amikacin was the lowest(51.9%).Among52strains of A.baumannii,46were multidrug resistant strains,and3were extensively drug resistant strains.ConclusionA.baumannii HAI is most serious in NICU of extremely premature infants,resistance rates to commonly used antimicrobial agents are high.

关 键 词：新生儿重症监护病房 鲍曼不动杆菌 医院感染 耐药性 

分 类 号：R378.99[医药卫生—病原生物学]