鲍曼不动杆菌及其耐药性的流行病学分析  

Epidemiological analysis and drug resistance analysis of acinetobacter baumannii

作　　者：傅美芹[1] 饶东平 余德基 FU Meiqin;RAO Dongping;YU Deji(The Department of Clinical Laboratory of Jiangmen Central Hospital;Department of Medical Records of Jiangmen Central Hospital,Guangdong,529030,China)

机构地区：[1]江门市中心医院检验科,广东江门529030 [2]江门市中心医院病案科,广东江门529030

出　　处：《新疆医学》2020年第10期1059-1062,共4页Xinjiang Medical Journal

基　　金：江门市医疗卫生领域科技计划项目(项目编号:2017020400410004664)。

摘　　要：目的利用描述性流行病学方法分析鲍曼不动杆菌的流行病学特征及其耐药性,为有效预防鲍曼不动杆菌的感染和临床合理选用抗菌药物提供依据。方法通过WHONET5.6软件收集2017-2018年江门市某三甲医院750例感染鲍曼不动杆菌患者临床资料及其药敏结果,采用描述性流行病学方法分析鲍曼不动杆菌流行病学分布及其耐药特征。结果 750例鲍曼不动杆菌感染病例中有348例为多重耐药鲍曼不动杆菌;鲍曼不动杆菌主要感染45岁以上人群,共588例(78.40%);不同年龄组多重耐药率不同(χ^2=44.24,P <0.01),多重耐药率较高为75~岁组(56.76%)和80~95岁组(55.41%);鲍曼不动杆菌感染病例主要分布的病区是ICU(37.47%)。鲍曼不动杆菌对头孢曲松耐药率最高,对米诺环素耐药率最低;2018年鲍曼不动杆菌对氨苄西林/舒巴坦、哌拉西林/三唑巴坦、头孢他啶、头孢吡肟、头孢曲松、美罗培南、亚胺培南、妥布霉素、环丙沙星的耐药率高于2017年。结论在诊疗过程中,需对ICU、神经外科、呼吸科45岁以上患者重点监测,做好医院感染防控措施和合理使用抗生素,以减少鲍曼不动杆菌的感染及其耐药菌株的播散。Objective To analyze the epidemic characteristics of acinetobacter baumanii and its resistance to antibiotics in a hospital of Jiangmen. Methods WHONET5.6 software was adopted to collect clinical data of 750 patients who were infected with acinetobacter baumannii. And the epidemic characteristics and drug resistance change of acinetobacter baumanii were analyzed by using descriptive study. Results A total of 750 acinetobacter baumanniis were collected, while 348 strains were multi-drug resistant;Acinetobacter baumannii mainly infected people above the age of 45 years old, accounting for 78.40%;The rates of multi-drug resistance were different in different age groups(χ^2= 44.24,P < 0.01);Acinetobacter baumandii mainly distributed in ICU(37.47%);The highest drug-resistance to acinetobacter baumannii was ceftriaxone, and the resistance rates of acinetobacter baumannii to ampicillin/sulbactam, piperacillin/trizobartan, ceftazidine, cefepime, ceftriaxone, meropenem, imipenem, tobramycin and ciprofloxacin in 2018 were higher than those in2017. Conclusions People above the age of 45 years old in the ICU, Neurosurgery and Department of Respiratory Medicine should be mainly monitored. It is necessary to strengthen hospital infection control. The control measures of infection and rational use of antibiotics should be taken to reduce the infection of acinetobacter baumannii and the spread of drug-resistant strains.

关 键 词：鲍曼不动杆菌 耐药性 多重耐药 

分 类 号：R446.5[医药卫生—诊断学] R969.3[医药卫生—临床医学]