2014-2019年某教学医院鲍氏不动杆菌分布及其耐药性趋势  

Distribution and drug resistance trend of Acinetobacter baumannii strains in a teaching hospital from 2014 to 2019

作　　者：孙迎娟[1] 薛莉[1] 唐一琳 李慧[2] 何宏[2] SUN Ying-juan;XUE Li;TANG Yi-lin;LI Hui;HE Hong(The Affliated Hospital of Qingdao University,Qingdao,Shandong 266555,China)

机构地区：[1]青岛大学附属医院西海岸院区护理院感处,山东青岛266555 [2]青岛大学附属医院西海岸院区检验科,山东青岛266555

出　　处：《中华医院感染学杂志》2022年第1期11-15,共5页Chinese Journal of Nosocomiology

摘　　要：目的 探讨鲍氏不动杆菌(AB)感染的临床分布特征、耐药变迁,指导临床合理使用抗菌药物,有效控制感染。方法 分析青岛大学附属医院2014-2019年住院患者检出AB的标本来源,采用全自动微生物分析仪进行细菌鉴定和药敏试验。按照美国临床与实验室标准化委员会(CLSI) M100进行药敏结果判定。结果 共分离AB 3 681株,标本来源以下呼吸道为主,占86.61%。AB分离率呈逐年上升趋势(χ^(2)=80.308,P<0.001),尤其是2016年度AB分离率显著升高,耐碳青霉烯鲍氏不动杆菌(CR-AB)检出率由45.47%升高到73.93%,呈逐年上升趋势(χ^(2)=151.716,P<0.001)。AB对临床常用的抗菌药物耐药率呈逐年上升趋势;2014、2015年AB对临床常用抗菌药物的耐药率均低于53.55%;2016年后,AB对多种抗菌药物的耐药率上升显著,除替加环素、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦外,AB对常用抗菌药物的耐药率均超过60.00%。除头孢他啶外,呼吸道和血流感染来源的AB对临床常用抗菌药物的耐药率比较差异无统计学意义。结论 AB的分离率及耐药率逐年升高,CR-AB检出率也呈逐年上升趋势,为遏制细菌耐药、防控CR-AB医院感染,医院应加强对AB感染与耐药监测与分析,规范抗菌药物使用管理。OBJECTIVE To explore the clinical distribution and drug resistance of Acinetobacter baumannii so as to provide guidance for reasonable clinical use of antibiotics and effectively control infection. METHODS The specimens sources of the A.baumannii strains that were isolated from the patients who were hospitalized in the Affiliated Hospital of Qingdao University from 2014 to 2019 were observed, the strains were identified by using automatic microorganism analyzer, the drug susceptibility testing was performed, and the result of drug susceptibility testing was determined based on Clinical and Laboratory Standards Institute(CLSI) M100. RESULTS A total of 3 681 strains of A.baumannii were isolated, 86.61% of which were isolated from lower respiratory tract specimens. The isolation rate of A.baumannii strains was increased year by year(χ^(2)=80.308,P<0.001), the isolation rate of A.baumannii was significantly increased in 2016, the isolation rate of carbapenem-resistant Acinetobacter baumannii(CRAB) strains was increased from 45.47% to 73.93%, showing upward trend(χ^(2)=151.716, P<0.001). The drug resistance rates of the A.baumannii strains to the commonly used antibiotics were increased year by year;the drug resistance rates of the A.baumannii strains to the commonly used antibiotics were less than 53.55% in 2014 and 2015. After 2016, the drug resistance rates of the A.baumannii strains to some antibiotics were significantly increased, and the drug resistance rates of the A.baumannii strains to the commonly used antibiotics, except for tigecycline, cefoperazone-sulbactam and piperacillin-tazobactam, were more than 60.00%. There was no significant difference in the drug resistance rate to the commonly used antibiotics except for ceftazidime between the A.baumannii strains isolated from respiratory tract specimens and the A.baumannii strains isolated from the blood specimens. CONCLUSION The isolation rate and drug resistance rate of the A.baumannii strains are increased year by year, the detection rate of CRAB strains

关 键 词：鲍氏不动杆菌 抗菌药物 耐药率 医院感染 

分 类 号：R378[医药卫生—病原生物学]