2017-2019年耐碳青霉烯类鲍曼不动杆菌分布和耐药性分析  

Analysis of distribution and drug resistance of carbapenem-resistant Acinetobacter baumanii strains 2017-2019

作　　者：杨新原 忽胜和 赵卫东 王源 杨娅 马霞 YANG Xinyuan;HU Shenghe;ZHAO Weidong;WANG Yuan;YANG Ya;MA Xia(the First Affiliated Hospital of Dali University,Dali,Yun′nan 671000,China)

机构地区：[1]大理大学第一附属医院检验科,云南大理671000

出　　处：《现代医药卫生》2020年第19期3062-3064,3068,共4页Journal of Modern Medicine & Health

基　　金：云南省教育厅科学研究基金项目(2016ZDX104)。

摘　　要：目的了解该院2017-2019年245株耐碳青霉烯类鲍曼不动杆菌(CRAB)来源分布及耐药性,为临床治疗和院感控制提供依据。方法回顾性分析该院2017-2019年245株CRAB标本来源、临床科室来源及耐药率。结果245株CRAB主要分离自痰标本(占78.37%),其次主要为分泌物、全血、深静脉导管尖端等标本;临床科室来源分布主要为重症监护病房(ICU)和急诊重症监护病房(EICU),共占77.14%,其次主要为呼吸内科、脊柱外科、神经外科等科室。CRAB对氨苄西林、阿莫西林、头孢唑林、氨曲南、头孢吡肟、头孢他啶、头孢曲松、环丙沙星、亚胺培南、哌拉西林/他唑巴坦、四环素、复方磺胺甲噁唑、左旋氧氟沙星、呋喃妥因耐药率均为100.00%(前4种为天然耐药);对米诺环素的耐药率为98.78%;对头孢哌酮/舒巴坦的耐药率为86.53%;对庆大霉素耐药率最低,仅为8.16%。结论CRAB主要分离自痰标本,科室分布主要为ICU和EICU,对多种抗菌药物呈高耐药性。院感防控工作应以易感人群及重点科室为主,尤应重视呼吸机等医疗设备消毒灭菌;同时应严守合理用药原则,并加大新疗法研发力度。Objective To understand the specimen distribution,clinical distribution and drug resistance of carbapenem-resistant Acinetobacter baumannii(CRAB)strains isolated from 2017 to 2019 in this hospital.Methods Specimen distribution,clinical distribution and drug resistance rate of the 245 CRAB strains isolated from 2017 to 2019 were retrospectively analyzed.Results Mainly of the 245 CRAB strains were isolated from sputum specimens,accounting for 78.37%,and followed by specimens of secretions,whole blood,deep vein catheter tips,and so on.Most of the strains were from the Intensive Care Unit(ICU)and the Emergency Intensive Care Unit(EICU),totally accounting for 77.14%,and followed by Department of Respiratory Medicine,Department of Spinal Surgery,Department of Neurosurgery,and so on.The drug resistant rates of CRAB to amoxicillin,ampicillin,cefazolin,aztreonam,cefepime,ceftazidime,ceftriaxone,ceftriaxone,ciprofloxacin,imipenemand,piperacillin/tazobactam,tetracycline,compound sulfamethoxazole,levofloxacin and nitrofurantoin were all 100.00%,and with natural resistance to the first four drugs.The resistant rate to minocycline was 98.78%,to cefoperazone/sulbactam was 86.53%,and that to gentamicin was only 8.16%,which was the lowest.Conclusion CRAB strains could be mainly isolated from sputum specimens,and from ICU and EICU,and with high resistance to a variety of antibacterial drugs.The controlling of nosocomial infections should be focused on the susceptible population and the key department,especially the sterilization of breathing machine and other equipment.At the same time,drugs should be prescribed strictly according to the principle of rational use of antimicrobial drugs,and new treatments should be vigorously researched and developed.

关 键 词：耐碳青霉烯类鲍曼不动杆菌 抗菌药物 药物耐受性 流行病学 

分 类 号：R446[医药卫生—诊断学]