鲍曼不动杆菌感染和耐药性分析

Analysis on infection and drug resistance of Acinetobacter baumannii

目的探讨中山大学附属第三医院鲍曼不动杆菌感染及耐药情况。方法回顾性分析2012年6月至2014年12月中山大学附属第三医院发生鲍曼不动杆菌感染的209例患者临床资料。其中男160例,女49例;平均年龄(55±18)岁。患者均签署知情同意书,符合医学伦理学规定。观察鲍曼不动杆菌来源、病区分布及耐药性。耐药率的比较采用χ2检验及Bonferroni法。结果全院共分离出236株鲍曼不动杆菌,其中分离出最多的科室为肝移植科(50株,21.2%),其次是康复科(34株,14.4%)和外科ICU(21株,8.9%)。3个病区中鲍曼不动杆菌主要来源均为痰标本,分别占各自来源的84%、76%、71%,且均对临床常用抗生素有较高的耐药性。肝移植科鲍曼不动杆菌对磺胺甲噁唑的耐药率为76%,明显高于外科ICU的33%(χ2=11.60,P<0.017)。结论我院鲍曼不动杆菌检出最多的科室为肝移植科,其次为康复科和外科ICU,痰标本为其主要来源。3个病区检出的鲍曼不动杆菌对常用抗生素均具有较强的耐药性。

Objective To investigate the infection and drug resistance ofAcinetobacter baumannii in the Third Affiliated Hospital of Sun Yat-sen University. Methods Clinical data of 209 patients infected with Acinetobacter baumannii in the Third Affiliated Hospital of Sun Yat-sen University between June 2012 and December 2014 were retrospectively analyzed. Among the patients, 160 were males and 49 were females with the average age of （55±18） years old. The informed consents of all patients were obtained and the local ethical committee approval was received. The specimen source, ward distribution and drug resistance of Acinetobacter baumannii were observed. The comparison of drug resistance was conducted using Chi-square test and Bonferroni test. Results Two hundred and thirty-six strains ofAcinetobacter baumannii were isolated in the hospital, and most were isolated from Department of Liver Transplantation （50 strains, 21.2%）, the next were Department of Rehabilitation （34 swains, 14.4%） and Surgical Intensive Care Unit （SICU） （21 sWains, 8.9%）. Sputum specimens were the main source ofAcinetobacter baumannii, respectively accouting for 84%, 76% and 71% in the three wards, where Acinetobacter baumannii had high drug resistance to the common antibiotics used in clinical. The drug resistance rate to sulfamethoxazole ofAcinetobacter baumannii in Department of Liver Transplantation was 76%, significantly higher than 33% of SICU （x^2=11.60, P〈0,017）. Conclusions Acinetobacter baumannii is found most in Department of Liver Transplantation, which is followed by Department of Rehabilitation and SICU. Sputum specimen is the main source ofAcinetobacter baumannii. Acinetobacter baumannii detected in the three wards has a high drug resistance to common antibiotics.