2016～2018年新疆某院1322株鲍曼不动杆菌临床分布及耐药性分析  

Analysis of clinical distribution and drug resistance of 1322 strains of Acinetobacter baumannii in a hospital of Xinjiang Uygur Autonomous Region in 2016-2018

作　　者：张红梅[1] 张玉[1] 段玮[1] 王晓倩 杨洁[1] ZHANG Hong-mei;ZHANG Yu;DUAN Wei;WANG Xiao-qian;YANG Jie(Department of Laboratory,the First Affiliated Hospital of the Medical College,Shihezi University,Xinjiang Uygur Autonomous Region,Shihezi 832008,China)

机构地区：[1]石河子大学医学院第一附属医院检验科

出　　处：《中国当代医药》2019年第29期179-182,F0004,共5页China Modern Medicine

摘　　要：目的了解鲍曼不动杆菌(AB)在不同病区的医院感染现状及耐药性差异,为有效预防及治疗医院AB感染提供依据,以期指导临床合理用药,降低医院感染率。方法于某院2016年1月~2018年12月住院患者中分离AB 1322株,回顾性分析其标本和病区来源,以及耐药性变迁情况。结果共分离病原菌1322株,病区来源主要为重症监护室(ICU,61.9%)、神经外科(25.8%)和呼吸内科(7.3%)。标本来源主要为痰液(80.3%),其次为分泌物及脓液、尿液、血液和胸腔积液及腹水,分别占9.1%、5.0%、3.7%、1.9%;各年度AB占分离病原菌的构成比分别为31.2%、30.4%、38.4%。2016~2018年AB对大多数抗菌药物的耐药率有上升趋势,对阿米卡星和头孢哌酮/舒巴坦的耐药率由2016年的60.14%和16.67%增至2018年的81.82%和45.71%;对复方新诺明的耐药率由2016年的34.42%降至2018年的31.90%;2016~2018年,除对氨苄西林/舒巴坦、复方新诺明、替加环素、头孢哌酮/舒巴坦和妥布霉素的耐药率较低以外,其余8种抗菌药物的耐药率均>60.00%。结论该院AB病区和标本来源主要为ICU和痰液;AB对常用抗菌药物的耐药率较高,应加强AB的耐药性监测,以减少多重耐药菌株的产生。Objective To understand the difference of hospital infection status and drug resistance of Acinetobacter baumannii(AB) in different wards, to provide a basis for the effective prevention and treatment of AB infection, in order to guide the rational use of drugs and reduce the hospital infection rate. Methods From January 2016 to December2018, 1322 strains AB were isolated from hospitalized patients. The specimens and ward sources and drug resistance changes were analyzed retrospectively. Results The results showed that 1322 strains of pathogens were isolated. The main wards were intensive care unit(ICU, 61.9%), neurosurgery department(25.8%) and respiratory medicine department(7.3%). The source of the specimen was mainly sputum(80.3%), followed by secretions and pus, urine, blood and pleural effusions and ascites, accounting for 9.1%, 5.0%, 3.7%, and 1.9% respectively. The composition ratio of AB to isolated pathogens in each year was 31.2%, 30.4%, and 38.4%, respectively. The resistance rate of AB to most antibacterial drugs was on the rise in 2016-2018. In addition, the resistance rate to Amikacin and Cefoperazone/Sulbactam increased from 60.14% and 16.67% in 2016 to 81.82% and 45.71% in 2018. The resistance rate to Compound Sulfamethoxazole decreased from 34.42% in 2016 to 31.90% in 2018. From 2016 to 2018, in addition to the low resistance rate to Ampicillin/Sulbactam, Cotrimoxazole, Tigecycline, Cefoperazone/Sulbactam and Tobramycin, the remaining8 antibacterials` resistance rate was greater than 60.00%. Conclusion The AB ward and specimens are mainly ICU and sputum. AB has a high resistance rate to commonly used antibiotics, and AB resistance monitoring should be strengthened to reduce the emergence of multi-drug resistant strains.

关 键 词：鲍曼不动杆菌 耐药率 临床分布 重症监护室 

分 类 号：R378[医药卫生—病原生物学]