多重耐药鲍曼不动杆菌临床分布及变迁趋势  

Clinical distribution and trend of multidrug resistant Acinetobacter baumannii

作　　者：李富升 郭巧梅[1] 李志夫[1] 徐阳颺[1] 辛敏 娄加陶[1] LI Fusheng;GUO Qiaomei;LI Zhifu;XU Yangyang;XIN Min;LOU Jiatao(Department of Clinical Laboratory, Shanghai Chest Hospital,the Chest Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200030,China;Shanghai Jiaotong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海市胸科医院上海交通大学附属胸科医院检验科,上海200030 [2]上海交通大学医学院,上海200030

出　　处：《检验医学》2019年第10期894-896,共3页Laboratory Medicine

摘　　要：目的分析上海市胸科医院分离的鲍曼不动杆菌(AB)和多重耐药鲍曼不动杆菌(MDR-AB)临床分布特点及变迁趋势,为控制MDR-AB感染提供理论依据。方法 采用微生物质谱鉴定系统对上海市胸科医院2015-2017年分离出的499株AB进行菌株鉴定及体外药物敏感性试验,同时分析相关临床资料。结果 2015-2017年,AB的检出率逐年递增(χ^2=7.168,P<0.05),但MDR-AB的检出率逐年降低(χ^2=35.086,P<0.01);男性患者AB和MDR-AB检出率高于女性患者(P>0.05);AB和MDR-AB均以60~69岁患者检出率最高,70~79岁患者MDR-AB检出率呈逐年上升趋势(χ^2=6.775,P<0.05)。AB和MDR-AB主要分离自痰样本,检出率最高的科室为重症监护病房(ICU)。结论 上海市胸科医院AB检出率逐年递增,应加强对MDRAB的监测,做好消毒隔离,控制多重耐药菌株的发展。Objective To analyze the clinical distribution and trend of Acinetobacter baumannii(AB) and multidrug resistant Acinetobacter baumannii(MDR-AB) isolated in Shanghai Chest Hospital,and to provide a reference for controlling MDR-AB infection. Methods Totally,499 isolates of AB isolated in Shanghai Chest Hospital from 2015 to 2017 were identified by VITEK MS microbial mass spectrometry identification system. The drug susceptibility test in vitro was carried out by VITEK-2 COMPACT,and the related clinical data were analyzed. Results The detection rate of AB increased from 2015 to 2017(χ^2=7.168,P<0.05),while the detection rate of MDR-AB decreased year by year(χ^2=35.086,P<0.01). The detection rates of AB and MDR-AB in male patients were higher than those in female patients(P>0.05). The detection rates of AB and MDR-AB all reached the highest in patients of 60-69 years old,and there was a yearly upward trend of MDR-AB detection rate in patients of 70-79 years old(χ^2=6.775,P<0.05). The specimens with AB and MDR-AB were mainly sputum specimens,most of which were from intensive care unit(ICU) of Shanghai Chest Hospital. Conclusions With the increasing of AB detection rate,the monitoring of MDR-AB should be strengthened,and disinfection and isolation should be done well to control the development of multidrug resistant isolates.

关 键 词：鲍曼不动杆菌 多重耐药 检出率 变迁趋势 

分 类 号：R446.1[医药卫生—诊断学]