重庆市4家三级甲等综合医院2017年至2019年鲍曼不动杆菌检出及耐药情况分析  

Detection and Drug Resistance of Acinetobacter Baumannii of Four GradeⅢ-A General Hospitals in Chongqing from 2017 to 2019

作　　者：陈和莉 程林 熊丽蓉 李頔[2] 李飞 程模 孙凤军 CHEN Heli;CHENG Lin;XIONG Lirong;LI Di;LI Fei;CHENG Mo;SUN Fengjun(Department of Pharmacy,The First Affiliated Hospital of Army Medical University,Chongqing,China 400038;Department of Pharmacy,The Second Affiliated Hospital of Chongqing Medical University,Chongqing,China 400016;Department of Pharmacy,Qianjiang Central Hospital,Chongqing,China 409099;Department of Pharmacy,Dianjiang People′s Hospital,Chongqing,China 408300)

机构地区：[1]中国人民解放军陆军军医大学第一附属医院药学部,重庆400038 [2]重庆医科大学附属第二医院药剂科,重庆400016 [3]重庆市黔江中心医院药学部,重庆409099 [4]重庆市垫江县人民医院药剂科,重庆408300

出　　处：《中国药业》2022年第15期28-32,共5页China Pharmaceuticals

基　　金：重庆市科卫联合医学科研项目[2020MSXM060]。

摘　　要：目的了解鲍曼不动杆菌在重庆地区的耐药特征,为临床合理选用抗菌药物提供参考。方法回顾性分析2017年至2019年重庆市4家三级甲等综合医院[中国人民解放军陆军军医大学第一附属医院(以下简称西南医院)、重庆医科大学附属第二医院(以下简称重医附二院)、重庆市垫江县人民医院(以下简称垫江医院)和重庆市黔江中心医院(以下简称黔江医院)]鲍曼不动杆菌的检出和耐药情况,统计鲍曼不动杆菌的检出率、科室分布、菌株来源,以及对常用抗菌药物的耐药率。结果2019年,除西南医院和黔江医院外,重医附二院和垫江医院鲍曼不动杆菌检出率均较2017年上升;各医院鲍曼不动杆菌均主要来源于痰液,主要分布在重症监护室、神经外科、烧伤科(西南医院)。西南医院2017年至2019年鲍曼不动杆菌对大部分检测药品的耐药率呈下降趋势,主要为50%~75%,2019年对氨苄西林、氨曲南的耐药率较2017年升高且高于75%,对其余检测药品的耐药率均低于75%,其中2018年和2019年对左氧氟沙星的耐药率均低于35%;重医附二院鲍曼不动杆菌对检测药品的耐药率呈波动变化,2019年的耐药率整体上升,对大部分药品的耐药率超过75%,其中对阿莫西林克拉维酸、氨苄西林、氨曲南、头孢曲松的耐药率均为100%,对阿米卡星、庆大霉素、妥布霉素、复方新诺明的耐药率均为35%~75%;垫江医院2017年至2019年鲍曼不动杆菌对环丙沙星、头孢他啶、亚胺培南、头孢吡肟、哌拉西林他唑巴坦的耐药率持续上升,对左氧氟沙星的耐药率持续下降,对其余检测药品的耐药率呈波动变化,2019年对阿米卡星、美罗培南、哌拉西林他唑巴坦、头孢哌酮舒巴坦的耐药率均超过75%,对左氧氟沙星的耐药率低于35%;黔江医院鲍曼不动杆菌对检测药品的耐药率呈波动变化,除2017年的亚胺培南外,对所检测药品的耐药率均低于75%,对复Objective To understand the drug resistance characteristics of Acinetobacter baumannii in Chongqing,and to provide a reference for the rational use of antibiotics in the clinic.Methods The detection and drug resistance of Acinetobacter baumannii in the four gradeⅢ-A general hospitals including the First Affiliated Hospital of Army Medical University(hereinafter referred to as the Southwest Hospital),the Second Affiliated Hospital of Chongqing Medical University,the Dianjiang People's Hospital(hereinafter referred to as the Dianjiang Hospital)and the Qianjiang Central Hospital(hereinafter referred to as the Qianjiang Hospital)in Chongqing from 2017 to 2019 were retrospectively analyzed.The detection rate,department distribution,strain source and drug resistance rate of Acinetobacter baumannii to common antibiotics were counted.Results Compared with that in 2017,the detection rate of Acinetobacter baumannii in the Second Affiliated Hospital of Chongqing Medical University and the Dianjiang Hospital increased except the Southwest Hospital and the Qianjiang Hospital in 2019.Acinetobacter baumannii in all hospitals was mainly from the sputum and distributed in the intensive care unit,neurosurgery department and burn department(the Southwest Hospital).From 2017 to 2019,the drug resistance rate of Acinetobacter baumannii to the most tested drugs in the Southwest Hospital showed a downward trend,mainly 50%-75%.Compare with that in 2017,the drug resistance rate of Acinetobacter baumannii to ampicillin and aztreonam was higher than 75%in the Southwest Hospital in 2019,while that of Acinetobacter baumannii to the other tested drugs was lower than 75%,and that of Acinetobacter baumannii to levofloxacin in 2018 and 2019 was lower than 35%.The drug resistance rate of Acinetobacter baumannii to the tested drugs in the Second Affiliated Hospital of Chongqing Medical University fluctuated,that of Acinetobacter baumannii rose as a whole in 2019,and that of Acinetobacter baumannii to the most drugs was higher than 75%.The drug re

关 键 词：鲍曼不动杆菌 检出率 耐药率 科室分布 菌株来源 合理用药 

分 类 号：R95[医药卫生—药学] R978.1