某基层综合医院临床感染鲍曼不动杆菌的调查分析  

Investigation and analysis of clinical infection with Acinetobacter baumannii in a grassroots comprehensive hospital

作　　者：李希涛[1] 王艳[2] 周秀丽[1] 张静[1] LIXi-tao;WANG Yan;ZHOU Xiu-li(Department of Clinical Laboratory Medicine,People's Hospital of Pingyin County,Shandong Pingyin 250400)

机构地区：[1]平阴县人民医院检验科,山东平阴250400 [2]平阴县人民医院院感科,山东平阴250400

出　　处：《医学检验与临床》2024年第8期34-38,共5页Medical Laboratory Science and Clinics

摘　　要：目的:探讨某基层综合医院鲍曼不动杆菌的临床感染分布特点及耐药性,为有效控制医院感染提供实验依据。方法:对某基层综合医院2020年10月-2023年3月临床标本中培养分离的262株鲍曼不动杆菌感染分布及药物敏感性进行调查分析,应用WHONET5.6软件对数据进行统计。结果:262株鲍曼不动杆菌主要分离自痰液、尿液,分别占63.74%、20.99%;从临床感染科室分布来看,该菌株感染主要来自重症医学科(ICU)、肿瘤科、呼吸内科和内分泌科,分别占32.06%、15.27%、12.21%、9.92%。262株鲍曼不动杆菌对头孢吡肪、庆大霉素、哌拉西林、氨苄西林/舒巴坦、美罗培南、左氧氟沙星、亚胺培南、头孢他啶、环丙沙星、哌拉西林/他唑巴坦、妥布霉素、替卡西林/克拉维酸耐药率均>50%;对阿米卡星、米诺环素、替加环素、多粘菌素耐药性较低,耐药率在2.0%-28%之间。分离碳青霉烯类耐药鲍曼不动杆菌(CRAB)153株,占58.40%,对奎诺酮类、氨苄西林复合剂、哌拉西林及复合剂、第三、四代头孢类和碳青霉烯类耐药率均>90%。结论:基层综合医院鲍曼不动杆菌对常用抗菌药物的耐药性普遍较高,尤其CRAB耐药严重。微生物实验室应加强耐药性监测,临床应积极采取预防措施,控制、减少多药耐药菌株的产生与传播。Objective:To explore the distribution characteristics of clinical infection,and drug resistance of Acinetobacter baumanni strains in a grass root general hospital,so as to provide laboratory evidence for the effective control of hospital infections.Methods:The distribution of infection,and drug resistance of the 262 strains of Acinetobacter baumanni isolated from the clinical specimens between Oct 2020 and Mar 2023 were investigated and analyzed,and the statistical analysis was performed using the WHONET5.6 softwere.Results:The 262 Acinetobacter baumanni strains were mainly isolated from sputum and urine specimens,accounting for 63.74%and 20.99%respectively;as for the distribution of clinical infection in departments,infection of the strains mainly happened in ICU,oncology,respiratory and endocrinology departments,accounting for 32.06%,15.27%,12.21%and 9.92%respectively.The drug resistance rates of 262 Acinetobacter baumannii trains were more than 50%to cefepime,gentamicin,piperacillin,ampicillin/sulbactam,meropenem,levofloxacin imipenem,ceftazidime,ciprofloxacin,piperacillin/tazobactam,tobramycin and ticarcillin/clavulanic acid;while the drug resistance rates to amikacin,minocycline,tigecycline and polymyxin were relatively low,ranging from 2.0%to 28%.153 strains of carbapenem-resistant Acinetobacter baumannii were isolated,accounting for 58.40%.The drug resistance rates to quinolones,ampicillin compound,piperacillin and its compound,third and fourth generation caphalosporins,and carbapenems were all over 90%.Conclusion:Acinetobacter baumannii is highly resistant to common antibiotics in the grass root general hospital,and especially,the drug resistance of carbapenem-resistant Acinetobacter baumannii is severe.Microbial laboratories should strengthen the surveillance of drug resistance,and preventive measures should be actively taken in clinical practice to control the generation and spread of multidrug resistant strains.

关 键 词：鲍曼不动杆菌 临床分布 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]