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区域性三级综合医院鲍氏不动杆菌耐药趋势及流行病学研究 被引量:2

Trend of drug resistance and epidemiology of Acinetobacter baumannii strains in regional tertiary general hospitals
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摘要 目的研究区域性三级综合医院鲍氏不动杆菌(AB)耐药性、分布以及分子流行特征,为医院长期监测及预防控制暴发流行奠定基础。方法收集2014年1-12月滨州市3所三级综合医院AB菌株683株,采用纸片扩散法检测耐药率,应用WHONET5.5统计软件进行分析;随机选取耐亚胺培南和(或)美罗培南AB菌株27株进行基因检测,应用ERIC-PCR法分析菌株同源关系。结果 AB分离率为5.50%,多药耐药AB(MDRAB)分离率为63.10%;耐药率最高为哌拉西林(62.08%),最低为米诺环素(21.08%),其次较低为头孢哌酮/舒巴坦(37.04%);主要碳青霉烯酶基因为OXA-23、OXA-24、OXA-51、OXA-64;存在4个克隆株分布于3所医院,A型是主要流行克隆株。结论滨州市区域性MDRAB分离率高,且耐药现象严重,提示头孢哌酮/舒巴坦和米诺环素可慎重作为MDRAB感染的经验用药;检测OXA-51可辅助快速鉴定AB;医院内存在不同型AB菌株播散以及同一克隆株在医院之间散在流行播散,应引起高度重视。 OBJECTIVE To explore the drug resistance,distribution,and molecular epidemiological characteristics of Acinetobacter baumannii strains in tertiary general hospitals so as to provide guidance for long-term surveillance and prevention of outbreak and prevalence.METHODS A total of 683 strains of A.baumannii were isolated from 3tertiary general hospitals from Jan 2014 to Dec 2014,then the drug resistance rates were detected by using disk diffusion method,and the statistical analysis was performed with the use of WHONET5.5software.Totally 27 strains of imipenem-resistant or meropenem-resistant A.baumannii were randomly selected for the detection of genes,and the homology of the strains was analyzed by means of ERIC-PCR.RESULTS The isolation rate of A.baumannii strains was 5.50%,and the isolation rate of multidrug-resistant A.baumannii(MDRAB)strains was 63.10%.The drug resistance rate to piperacillin was the highest(62.08%),the drug resistance rate to minocycline was the lowest(21.08%),and the drug resistance rate to cefoperazone-sulbactam was 37.04%.The major carbapenemase genes were as follows:OXA-23,OXA-24,OXA-51,OXA-64;there were 4clones which distributed in 3hospitals,and the type A was the most prevalent.CONCLUSION The isolation rate of MDRAB strains is high in Binzhou area;the strains are highly drug-resistant,indicating that cefoperazone-sulbactam and minocycline can be carefully chosen for empirical medication for the MDRAB infection.The detection of OXA-51 may facilitate the rapid identification of the A.baumannii strains.The different types of A.baumannii strains scatter in the hospitals,and the same clone strains are prevalent and spread among the hospitals,which should be attached great importance to.
出处 《中华医院感染学杂志》 CAS CSCD 北大核心 2016年第18期4104-4106,共3页 Chinese Journal of Nosocomiology
基金 山东省医药卫生科技发展计划(2015WS0491) 滨州市科技发展计划(2013ZC1802 2013ZC1714 2013ZC1711) 医院管理创新项目(FY2014GL06 FY2016GL02)
关键词 区域性 鲍氏不动杆菌 碳青霉烯酶 多药耐药菌 Regional Acinetobacter baumannii Carbapenemase Multidrug-resistant organism
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  • 1Tenover FC,Arbeit RD,Goering RV,et al.Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis:criteria for bacterial strain typing[J].J Clin Microbiol,1995,33(9):2233-2239.
  • 2刘玉岭,张会平,丁真,宋红岩,史广鸿.2006~2011年鲍曼不动杆菌耐药性变迁[J].中华全科医学,2013,11(7):1050-1051. 被引量:6
  • 3张小江,徐英春,俞云松,杨青,汪复,朱德妹,倪语星,孙景勇,孙自镛,简翠,胡云建,艾效曼,张泓,李万华,贾蓓,黄文祥,王传清,王爱敏,魏莲花,吴玲,卓超,苏丹虹,张朝霞,季萍,徐元宏,熊自忠,沈继录,单斌,杜艳.2009年中国CHINET鲍曼不动杆菌细菌耐药性监测[J].中国感染与化疗杂志,2010,10(6):441-446. 被引量:137
  • 4胡付品,朱德妹,汪复,蒋晓飞,孙自镛,陈中举,胡志东,李金,谢轶,康梅,徐英春,张小江,张朝霞,季萍,王传清,王爱敏,倪语星,孙景勇,俞云松,林洁,储云卓,田素飞,徐元宏,沈继录,单斌,杜艳,卓超,苏丹虹,张泓,孔菁,魏莲花,吴玲,胡云建,艾效曼.2013年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2014,14(5):365-374. 被引量:624
  • 5文细毛,付陈超,任南,邹明祥,赵艳华,吴安华.湖南省细菌耐药监测网2011年度监测报告[J].中国感染控制杂志,2012,11(5):321-327. 被引量:18
  • 6Perez F,Hujer AM,Hujer KM,et al.Global challenge of multidrug-resistant Acinetobacter baumannii[J].Antimicrob Agents Chemother 2007,51(10):3471-3484.

二级参考文献38

  • 1王辉,郭萍,孙宏莉,杨启文,陈民钧,朱元珏,徐英春,谢秀丽.碳青霉烯类耐药的不动杆菌分子流行病学及其泛耐药的分子机制[J].中华检验医学杂志,2006,29(12):1066-1073. 被引量:237
  • 2Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing[S]. Twentieth Informational Supplement, M100-S20. CLSI, 2010.
  • 3Arias CA. Murray BE. Antibiotic-resistant bugs in the 21st century-a clinical super-challenge[J].N Engl J Med. 2009. 360(5): 439-443.
  • 4Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing[S]. Twentyfourth informational supplement. 2014. M100-S24 Vol 34 No. 1.
  • 5Hu F. Chen S. Xu X. et al. Emergence of carbapenem-resistant clinical Enterobacteriaceae isolates from a teaching hospital in Shanghai. China[J]. J Med Microbiol , 2012. 61 (Pr 1): 132- 136.
  • 6Brink AJ. Feldman C. Grolman DC. et al. Appropriate use of the carbapenems[J]. S Afr Med J. 2004. 94 (10 Pt 2): 857-861.
  • 7Chen S. Hu F. Zhang X. et al. Independent emergence of colistin-resistant Enterobacteriaceae clinical isolates without colistin treatrnentj]]. J Clin Microbiol , 2011. 49( 11): 4022- 4023.
  • 8van Duin D. Kaye KS. Neuner EA. et al. Carbapenem-resistant Enterobacteriaceae: a review of treatment and outcomes[J]. Diagn Microbiol Infect Dis. 2013. 75(2): l1S-120.
  • 9Daikos GL. Tsaousi S. Tzouvelekis LS. et al. Carbapenemaseproducing Klebsiella pneumoniae bloodstream infections: lowering mortality by antibiotic combination schemes and the role of carbapenems [J]. Antimicrob Agents Chernother , 2014.58 (4): 2322-2328.
  • 10Tascini C. Tagliaferri E. Giani T. et al. Synergistic activity of colistin plus rifampin against colistin-resistant KPCproducing Klebsiella pneumoniae [J]. Antimicrob Agents Chernother , 2013. 57 (8): 3990-3993.

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