某三级医院鲍曼不动杆菌临床分布及耐药性变迁  

Change of clinicaldistribution and resistance of Acinetobacterbaumannii isolated from a tertiary hospital

作　　者：王丽恒[1] 刘婧 潘舒月[3] 林家福[1] WANG Li-heng;LIU Jing;PAN Shu-yue;LIN Jia-fu(Department of Infection,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000;Department of Clinical Laboratory,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000;Department of Rheumatology and Immunology,Chengdu Fifth People's Hospital,Chengdu 611130,Sichuan,China)

机构地区：[1]川北医学院附属医院感染科,四川南充637000 [2]川北医学院附属医院检验科,四川南充637000 [3]成都市第五人民医院风湿免疫科,四川成都611130

出　　处：《川北医学院学报》2024年第7期941-944,共4页Journal of North Sichuan Medical College

基　　金：四川省预防医学会资助项目(SCGK202111);四川省基层卫生事业发展研究中心资助项目(SWFZ23-Y-41)。

摘　　要：目的:分析川北医学院附属医院分离的鲍曼不动杆菌(AB)的临床分布及耐药情况,了解其变化趋势。方法:分析川北医学院附属医院分离的764株AB的临床分布及药敏试验结果,并与课题组前期研究结果进行对比分析。结果:本次检出的AB在各标本中及在临床科室的占比与川北医学院附属医院2004~2008年和2011~2014年报告数据存在统计学差异(P<0.05),三个时期均以痰标本检出率最高(73.1%~84.2%),ICU和神经外科占比位列前两位;近年急诊科的AB分离率高达17.3%。三个时期12种抗菌药的合计耐药率分别为69.2%、79.6%和58.1%(P<0.05)。2020~2021年,AB对所试13/16种抗菌药的耐药率均>50%。2020~2021年神经外科和ICU分离菌株对所试12种抗菌药的合计耐药率分别为66.5%和75.4%,较2011~2014年的耐药率(分别为79.7%和84.1%)降低(P<0.05)。结论:川北医学院附属医院AB主要见于呼吸道感染,以ICU、神经外科和急诊科较为常见。AB(尤其在ICU和神经外科病房)多重耐药现象较为严重。规范抗菌药物使用和加强细菌耐药性实时监测具有重要意义。Objective:To analyze the clinical distribution and drug resistance of Acinetobacter baumannii(AB)isolated from a tertiary hospital,to understand its change trend.Methods:The clinical distribution and drug susceptibility test results of 764 AB strains isolated were statistically analyzed,and to compare and analyze the results of previous literature reports in this hospital.Results:The proportion of AB detected in each specimen and in clinical departments was different from the data reported by the hospital in 2004~2008 and 2011~2014(P<0.05),and the detection rate of sputum specimens was the highest in the three periods(73.1%~84.2%),and the proportion of ICU and neurosurgery wardranked the top two.In recent years,the AB separation rate in the emergency department had been as high as 17.3%.The total resistance rates to 12 antimicrobials in the three periods were 69.2%,79.6%and 58.1%,respectively(P<0.05).In 2020~2021,AB s resistance rate to 13/16 antibacterial drugs tested was more than 50%.In 2020~2021,the total resistance rates of isolates in neurosurgical departmentand ICU to the 12 antibacterial drugs tested were 66.5%and 75.4%,which was lower than that in 2011-2014(79.7%vs.84.1%)(P<0.05).Conclusion:AB in our hospital is mainly seen in respiratory tract infection,and is more common in ICU,neurosurgery and emergency ward.Multidrug resistance of AB is more serious,especially in the ICU and neurosurgery wards.It is important to standardize the use of antimicrobials and strengthen real-time monitoring of bacterial resistance.

关 键 词：鲍曼不动杆菌 耐药性 分布 重症监护病房 神经外科病房 

分 类 号：R378[医药卫生—病原生物学]