儿科鲍氏不动杆菌感染的危险因素与耐药性研究

Risk factors and drug resistance for children with Acinetobacter baumannii infection

目的调查医院儿科患儿鲍氏不动杆菌感染情况、感染危险因素及耐药性,为儿科鲍氏不动杆菌感染的临床预防治疗提供参考依据。方法选取医院2012年12月-2015年12月儿科收治的患儿3 222例为研究对象,分离、培养并鉴定患儿的病原菌种类,对检出的鲍氏不动杆菌进行药敏试验,数据采用SPSS 19.0软件进行统计分析。结果 3 222例患儿样本中共培养出病原菌471株,以革兰阴性菌为主,共278株占59.02%;鲍氏不动杆菌是最主要的病原菌,占16.56%;机械通气、气管插管、抗菌药物使用时间和导尿管留置是患儿感染鲍氏不动杆菌的危险因素(P<0.05);鲍氏不动杆菌对氨曲南的耐药率最高,为97.44%。结论鲍氏不动杆菌是导致儿科感染的最主要病原菌,其对氨曲南的耐药率较高,对亚胺培南的耐药率较低,临床上应根据上述结果指导实施诊治。

OBJECTIVE To investigate the infection situation,risk factors and drug resistance for children with Acinetobacter baumannii in the hospital,so as to provide basis for the prevention of children with A.baumannii infection.METHODS A total of 3222 cases of patients in the department of pediatrics of the hospital from Dec.2012 to Dec.2015 were chosen as research objects.The pathogens were isolated,cultured and identified,and the detected A.baumannii were taken for susceptibility test.The data were analyzed by SPSS 19.0.RESULTS Totally 471 strains of pathogens were cultured in the 3222 cases of children samples,and mainly were 278 strains of gram-negative bacteria,accounting for 59.02%.A.baumannii was the main pathogen,accounting for 16.56%.The risk factors for children with A.baumannii infection were mechanical ventilation,endotracheal intubation,usage time of antibiotics and catheter indwelling（P〈0.05）.The resistant rate of A.baumannii to aztreonam was97.44%,which is the highest.CONCLUSION A.baumannii is the most important cause of pediatric infectious,it has a higher resistant rate to aztreonam,and a lower resistance rate to imipenem,so we should guide the implementation of clinical diagnosis and treatment based on the results.