2019—2021年上海市部分医院鲍曼不动杆菌的耐药性变迁  

Changes in drug resistance of Acinetobacter baumannii in some hospitals in Shanghai from 2019 to 2021

作　　者：葛忆琳[1] 季晓帆 张幸 王臻[1] 毕菁 刘倩[1] 张红芝[1] GE Yi-lin;JI Xiao-fan;ZHANG Xin;WANG Zheng;BI Jing;LIU Qian;ZHANG Hong-zhi(Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200331,China)

机构地区：[1]上海市疾病预防控制中心,上海200031

出　　处：《中国消毒学杂志》2023年第10期752-756,共5页Chinese Journal of Disinfection

基　　金：上海市公共卫生体系建设三年行动计划(2020-2022年)重点学科建设计划任务书(GWV-10.1-XK03)。

摘　　要：目的监测上海市2019—2021年部分医院鲍曼不动杆菌的耐药变迁,掌握临床分离株与环境分离株耐药流行趋势。方法采用BD 100系统和VITEK MS全自动快速微生物质谱检测系统鉴定细菌,采用MIC微量肉汤法测定抗菌药物最低浓度。结果收集上海市部分医院鲍曼不动杆菌临床与环境分离株共计1368株,三级医院临床分离株呈现多重耐药菌加剧,二级与三级医院耐碳青霉烯类鲍曼不动杆菌均呈上升趋势;三级医院环境分离株与临床分离株同期出现对β-内酰胺类、青霉素类和头孢菌素类的耐药率呈不同程度升高;二级医院环境分离株对头孢哌酮/舒巴坦的耐药率上升显著。结论3年期间上海市二级、三级医院耐碳青霉烯类鲍曼不动杆菌检出率呈上升趋势,环境分离株对β-内酰胺类、青霉素类和头孢菌素类抗菌药物呈上升趋势,需加强耐药监测以及密切关注病房中多个关键位置的污染状况以防医院感染的发生。Objective To monitor the changes in drug resistance of Acinetobacter baumannii in some hospitals in Shanghai from 2019 to 2021,and to understand the prevalence of drug resistance in clinical isolates and environmental isolates.Methods BD 100 system and VITEK MS automatic rapid microbial mass spectrometry detection system were used to identify bacteria,and MIC microbroth method was used to determine the minimum inhibitory concentration of antibacterial drugs.Results A total of 1368 clinical and environmental isolates of Acinetobacter baumannii were collected from some hospitals in this city.Clinical isolates from tertiary hospitals showed an increase in multidrug-resistant organisms,and carbapenem-resistant Acinetobacter baumannii showed an upward trend in both secondary and tertiary hospitals.The resistance rates of environmental isolates and clinical isolates in tertiary hospitals toβ-lactams antibacterial drugs penicillins and cephalosporins increased to varying degrees at the same time;the resistance rate of the environmental isolates in secondary hospitals to piperone/sulbactam increased significantly.Conclusion During the past three years,the detection of carbapenem-resistant Acinetobacter baumannii in secondary and tertiary hospitals in this city has shown an increasing trend,and environmental isolates resistant toβ-lactams antibacterial drugs penicillins and cephalosporins have shown an increasing trend.It is necessary to strengthen drug resistance monitoring and pay close attention to the contamination status of multiple key locations in the ward to prevent the occurrence of nosocomial infections.

关 键 词：鲍曼不动杆菌 耐药 医院 变迁 

分 类 号：R184[医药卫生—流行病学]