许昌市中心医院耐碳青霉烯类鲍曼不动杆菌耐药性及临床特征  

Drug Resistance and Clinical Characteristics of Carbapenem-Resistant Acinetobacter Baumannii in Xuchang Central Hospital

作　　者：艾根伟 张莹 AI Genwei;ZHANG Yin(Department of Clinical Laboratory,Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]许昌市中心医院检验科,河南许昌461000

出　　处：《河南医学研究》2025年第7期1237-1240,共4页Henan Medical Research

摘　　要：目的了解耐碳青霉烯类鲍曼不动杆菌(CRAB)的临床特征及耐药性变化,为指导临床合理用药,明确有效控制医院感染措施提供依据。方法收集许昌市中心医院2020—2022年住院患者的CRAB的菌株数据,分析其临床特征,并用细菌耐药性监测数据统计分析软件WHONET进行耐药性分析。结果2020—2022年医院检验科共检出鲍曼不动杆菌(AB)516株,其中CRAB菌株320株,占比62.02%。2020—2022年医院CRAB菌株数及菌株检出率逐年增高。CRAB菌株标本中分布中占比最高的是痰液,占比77.81%,其次是创面分泌物、尿液,分别占比6.88%、6.56%。CRAB菌株主要分布在重症医学科、呼吸重症监护科、急诊重症监护室、神经外科,其中重症医学科占比数量多,占比30.94%,CRAB不仅对碳青霉烯类抗生素耐药,对头孢菌素、β-内酰胺酶抑制剂均呈现较高的耐药率;同时对氨基糖苷类抗生素、喹诺酮类药物、复方磺胺甲噁唑的耐药率也较高,耐药率整体呈逐年上升趋势。CRAB对米诺环素较为敏感,但耐药率在这3 a也逐年上升;CRAB对多黏菌素B、替加环素较为敏感性较强。结论许昌市中心医院CRAB菌株主要分布在重症医学科、呼吸重症监护科、急诊重症监护室、神经外科,临床标本主要分布在痰液;CRAB具有多重耐药性,但多黏菌素B、替加环素对其具有较好的抗菌效果。Objective To understand the clinical characteristics and drug resistance changes of carbapenem-resistant Acinetobacter baumannii(CRAB),so as to provide a basis for guiding clinical rational drug use and clarifying effective measures to control hospital infection.Methods The CRAB strain data of inpatients in Xuchang Central Hospital from 2020 to 2022 were collected,and their clinical characteristics were analyzed.Results From 2020 to 2022,a total of 516 strains of Acinetobacter baumannii(AB)were detected in the hospital’s laboratory,including 320 strains of CRAB,accounting for 62.02%.The number and detection rate of CRAB strains in hospitals have been increasing year by year from 2020 to 2022.The highest proportion of CRAB strain specimens was sputum,accounting for 77.81%,followed by wound secretions and urine,accounting for 6.88%and 6.56%respectively.CRAB strains were mainly distributed in Intensive Care Unit,Respiratory Intensive Care Unit,Emergency Intensive Care Unit and Department of Neurosurgery.Among them,intensive care unit accounted for a large number,accounting for 30.94%.CRAB was not only resistant to carbapenem antibiotics,but also showed high resistance rate to cephalosporins andβ-lactamase inhibitors.At the same time,the resistance rate to aminoglycoside antibiotics,quinolones,and compound sulfamethoxazole was also high,and the overall resistance rate was increasing year by year.CRAB was sensitive to minocycline and polymyxin B,but the drug resistance rate had increased year by year in these three years.CRAB was more sensitive to polymyxin B and tigecycline.Conclusion The CRAB strains in Xuchang Central Hospital are mainly distributed in Intensive Care Unit,Respiratory Intensive Care Unit,Emergency Intensive Care Unit,and Department of Neurosurgery,and the clinical specimens are mainly distributed in sputum.CRAB has multiple drug resistance,but polymyxin B and tigecycline now have good antibacterial effect on it.

关 键 词：鲍曼不动杆菌 耐碳青霉烯类鲍曼不动杆菌 耐药性 临床特征 

分 类 号：R446.5[医药卫生—诊断学]