舟山海岛地区多重耐药鲍曼不动杆菌调查及替加环素对其药物敏感性研究

Investigation of multidrug-resistant Acinetobacter baumannii in Zhoushan Island and study on the sensitivity of tigecycline to Acinetobacter baumannii

目的分析舟山海岛地区多重耐药鲍曼不动杆菌调查结果及替加环素对其药物敏感性的影响。方法收集我院2016年1月~2017年5月150例多耐药鲍曼不动杆菌感染患者的各类标本。采用调查表形式调查多重耐药鲍曼不动杆菌感染患者的临床情况,如年龄、性别、病种、基础疾病、病程、用药情况、抗菌药物使用频率、免疫状况、有无侵入性操作、药敏结果等,统计分析患者感染多重耐药鲍曼不动杆菌的危险因素、好发人群等。通过常规培养、分离筛选出多重耐药鲍曼不动杆菌菌株150例,予Kirby-Bauer纸片扩散法置入培养基(MH)中进行药敏试验。研究本地区多重耐药鲍曼不动杆菌对替加环素、头孢哌酮舒巴坦钠的耐药及抑菌率。采用空白组、替加环素组、舒普深组及替加环素+舒普深组对150例多重耐药鲍曼不动杆菌进行耐药及抑菌效果的观察及分析。结果通过分析发现,年龄大、合并多种疾病、恶性肿瘤、病程长、用药种类单一、抗菌药物使用时间长是患者感染多重耐药鲍曼不动杆菌的危险因素。替加环素组的耐药率和抑菌率为10.0%和90.0%、舒普深组的耐药率和抑菌率为20.0%和80.0%,替加环素+舒普深组的耐药率和抑菌率为4.6%和95.4%。结论替加环素对多重耐药鲍曼不动杆菌具有较高的敏感度,并且通过与舒普深的联合应用,能够减少其耐药性,从而有效治疗多重耐药鲍曼不动杆菌引起的疾病。

Objective To analyze the investigation results of multi-drug resistant Acinetobacter baumannii in Zhoushan Island and the sensitivity of tigecycline to Acinetobacter baumannii. Methods Various types of specimens of 150 pa- tients with multi-drug resistant Acinetobacter baumannii infection in our hospital from January 2016 to May 2017 were collected. The clinical status of patients with multiple drug-resistant Acinetobacter baumannii infection, such as age, sex, disease, underlying disease, course of disease, medication status, frequency of antimicrobial use, immune status, in- vasive operation, medication sensitive results was investigated by using the form of the questionnaire. The risk factors for multiple drug resistance of Acinetobacter baumannii infection in patients and good people were statistically ana- lyzed. 150 cases of multi-drug resistant Acinetobacter baumannii strains were screened by conventional culture and iso- lated. And the drug susceptibility test was carried out by Kirby-Bauer paper diffusion placed into culture medium（MH）. The resistance and inhibitory rate of Acinetobacter baumannii to ticyclotaxel and eefoperazone sulbactam sodium in the region were studied. The antibiotic resistance and antibacterial effect of 150 cases of multi-drug resistant Acinetobacter baumannii were observed and analyzed by blank group, tigeeycline group, sulperazon group and tigecycline＋sulperazon group. Results The analysis revealed that older age, combination with multiple diseases, cancer, longer duration, a single type of medication, long time of antibiotics use ere the risk factors for patients to be infected with multiple drug resis- tant Acinetobacter baumannii infection.The resistant rate and antimicrobial rate of the tigecycline group were 10.0% and 90.0%, respectively. The resistant rate and antibacterial rate of the sulperazon group were 20.0% and 80.0%, re- spectively. The resistant rate and antibacterial rate were 4.6% and 95.4% in the tigecyeline＋sulperazon group. Conclu- sion Tigeeycline has a high sensitivity to multidrug-resistant Acinetobacter baumannii and its drug resistance can be reduced by co-administration with sulperazon, so as to effectively treat the diseases caused by muhidrug-resistant Aeinetobaeter baumannii.