心脏外科鲍曼不动杆菌感染病原学特征分析  

Etiological analysis of Acinetobacter baumannii infections in Cardiac Surgery

作　　者：张伟峰[1] 雷素扬[1] 赵俊涛[1] ZHANG Wei-feng;LEI Su-yang;ZHAO Jun-tao(Zhengzhou No.7 Peoples Hospital,Zhengzhou,China 450000)

机构地区：[1]郑州市第七人民医院

出　　处：《中国病原生物学杂志》2019年第5期596-599,共4页Journal of Pathogen Biology

摘　　要：目的分析心脏外科鲍曼不动杆菌感染病原学,以指导临床诊疗。方法收集心脏外科感染鲍曼不动杆菌患者样本,K-B纸片法分析鲍曼不动杆菌的耐药性。PCR扩增检测耐药基因,统计学分析鲍曼不动杆菌产生耐药株的相关因素。结果从心脏外科患者样本分离87株鲍曼不动杆菌,呼吸道、手术切口、纵隔、血液、泌尿道及其他感染部位分别分离37、14、11、9、6和10株。鲍曼不动杆菌对头孢吡肟、头孢噻肟、头孢他啶、阿米卡星、亚胺培南、左氧氟沙星、环丙沙星、庆大霉素、氨苄西林、氨曲南的耐药率分别为55.17%、66.67%、68.97%、27.59%、28.74%、55.17%、50.57%、33.33%、65.52%和100.00%。鲍曼不动杆菌OXA-23基因、OXA-58基因、TEM基因、PER基因、IMP基因检出率分别为41.38%、8.05%、29.89%、10.34%和17.24%。鲍曼不动杆菌耐药与患者性别无关(χ^2=0.1010,P=0.7506),与年龄(χ^2=5.3454,P=0.0208)、合并糖尿病(χ^2=4.8619,P=0.0275)、住院天数(χ^2=8.7139,P=0.0032)、是否采用人工气道(χ^2=8.7139,P=0.0032)、抗生素使用(χ^2=9.2104,P=0.0024)相关。结论心脏外科鲍曼不动杆菌感染部位主要是呼吸道,病原菌对常用抗菌药物都产生了一定程度的耐药性,耐药性发展可能与耐药基因的传播关系密切。临床应注意合理用药。Objectives To analyze the etiology of Acinetobacter baumannii infections in Cardiac Surgery in order to guide the treatment of this condition.Methods Samples from patients in Cardiac Surgery who were infected with A.baumannii were collected,and the drug resistance of A.baumannii was analyzed using the K-B method.Drug resistance genes were detected via amplification with PCR,and factors related to the multi-drug resistance of A.baumannii were statistically analyzed.Results Eighty-seven strains of A.baumannii were isolated from 177 patient samples.Thirty-seven strains were isolated from the respiratory tract,14 were isolated from surgical wounds,11 were isolated from the mediastinum,9 were isolated from blood,6 were isolated from the urinary tract,and 10 were isolated from some other site.The resistance of A.baumannii to cefepime was 55.17%,its resistance to cefotaxime was 66.67%,its resistance to ceftazidime was 68.97%,its resistance to amikacin was 27.59%,its resistance to imipenem was 28.74%,its resistance to levofloxacin was 55.17%,its resistance to ciprofloxacin was 50.57%,its resistance to gentamicin was 33.33%,its resistance to ampicillin was 65.52%,and its resistance to aztreonam was 100.00%.The oxa-23 gene was detected in 41.38%of strains,the oxa-58 gene was detected in 8.05%,the TEM gene was detected in 29.89%,the PER gene was detected in 10.34%,and the IMP gene was detected in 17.24%.Multi-drug-resistant strains of A.baumannii were not associated with gender(χ^2=0.1010,P=0.7506),There were significant differences in terms of age(χ^2=5.3454,P=0.0208),diabetes mellitus(χ^2=4.8619,P=0.0275),duration of hospitalization(χ^2=8.7139,P=0.0032),whether an artificial airway was created(χ^2=8.7139,P=0.0032),and antibiotic use(χ^2=9.2104,P=0.0024).Conclusion The main site of A.baumannii infection in Cardiac Surgery is the respiratory tract,and the bacterium has developed a certain degree of resistance to commonly used antimicrobials.Its development of drug resistance may be closely related to the spread of dru

关 键 词：心脏外科 鲍曼不动杆菌 感染 病原学 

分 类 号：R378[医药卫生—病原生物学]