非鲍曼不动杆菌的临床分布及感染特点分析  

Analysis on clinical distribution and infection characteristics of non-Acinetobacter Baumannii

作　　者：张婷[1] 毕茹茹 韩清珍 ZHANG Ting;BI Ruru;HAN Qingzhen(Center of Clinical Laboratory,the Fourth Affiliated Hospital of Soochow University,Suzhou 215123,China)

机构地区：[1]苏州大学附属第四医院临床检测中心,江苏苏州215123

出　　处：《现代医学》2024年第8期1266-1272,共7页Modern Medical Journal

摘　　要：目的:分析临床分离的非鲍曼不动杆菌的临床分布及感染特征。方法:收集苏州大学附属第四医院2021年1月至2023年6月分离的非鲍曼不动杆菌菌株197株,根据医院不动杆菌、皮特/赛氏不动杆菌及非醋酸钙-鲍曼不动杆菌(ACB)复合群进行分类,并比较其临床分布差异和感染特征。结果:非鲍曼不动杆菌的分离率逐年增加,不同的非鲍曼不动杆菌对15种药物的耐药率差异无统计学意义。非ACB复合群感染者平均年龄最高(69.68±14.65)岁,医院不动杆菌感染者平均住院时间最长(30.81±18.54)d、ICU入住率(31.25%)和恶化结局(9.38%)比例均最高,3类不动杆菌感染者平均住院时间、ICU入住率比较,差异有统计学意义(P<0.05)。非鲍曼不动杆菌多为医院获得性感染,与其他细菌混合检出多见。与单菌检出患者相比,混合检出患者男性比例、住院时间≥28 d比例、有创操作比例、有ICU入住史比例、白细胞计数、中性粒细胞比例和降钙素原水平均升高,且差异具有统计学意义(P<0.05)。结论:非鲍曼不动杆菌检出逐年增多,不同的非鲍曼不动杆菌其临床分布和感染特点不同,应加强院内对非鲍曼不动杆菌感染的关注和监测。Objective:To analyze the clinical distribution and infection characteristics of clinical isolates of non-Acinetobacter baumannii(non-A.baumannii).Methods:A total of 197 non-A.baumannii strains isolated from January 2021 to June 2023 at the Fourth Affiliated Hospital of Soochow University were collected.The strains were classified into A.nosocomialis,A.pittii/seifertii,and non-A.calcoaceticus-baumannii(ACB)complex,and their clinical distributions and infection characteristics were compared.Results:The isolation rate of non-A.baumannii had been increasing annually.There was no statistically significant difference in the drug resistance rates of the different non-A.baumannii strains to 15 types of drugs.The mean age of patients infected with non-ACB complex was the highest[(69.68±14.65)years].For A.nosocomialis infections,the average hospital stay was the longest[(30.81±18.54)d],the ICU admission rate(31.25%)and the proportion of adverse outcomes(9.38%)were all the highest among the three groups of non-A.baumannii infections.The differences in average hospital stay and ICU admission rates among the three types of non-A.baumannii infections were statistically significant(P<0.05).Non-A.baumannii infections were mostly hospital-acquired,and co-detection with other bacteria was common.Compared with patients with single bacterial detection,those with mixed bacterial detection had a higher proportion of male patients,a higher proportion of long hospital stays(≥28 d),a higher rate of invasive procedures,a higher rate of ICU stay history,increased white blood cell count,increased neutrophil ratio,and higher procalcitonin levels,with all differences being statistically significant(P<0.05).Conclusion:The detection of non-A.baumannii has been increasing yearly,and different non-A.baumannii strains exhibit different clinical distributions and infection characteristics.Therefore,increased attention and monitoring of non-A.baumannii infections in the hospital setting are warranted.

关 键 词：医院不动杆菌 皮特/赛氏不动杆菌 非醋酸钙-鲍曼不动杆菌复合群 临床分布 感染 

分 类 号：R446.5[医药卫生—诊断学]