228株鲍曼不动杆菌感染的临床分布和耐药性分析

Analysis of clinical distribution and drug resistance of Acinetobacter baumannii infection in 228 strains

目的分析鲍曼不动杆菌的临床感染情况和耐药性,为指导临床合理用药提供理论依据。方法选取2015年1月～2017年12月住院患者分离的228株鲍曼不动杆菌进行研究,应用Vitek 2 compact全自动微生物鉴定分析系统进行菌种鉴定,分析标本和科室分布情况,以及鲍曼不动杆菌的耐药性,所有数据应用细菌耐药性监测软件WHONET5.4进行统计分析。结果分离的鲍曼不动杆菌共有228株,在痰标本、伤口分泌物和尿液中的检出率较高,分别为154株(67.54%)、31株(13.60%)和14株(6.14%)。在科室分布上主要集中在重症监护病房,为108株(47.37%),其次为呼吸内科,为36株(15.79%)。鲍曼不动杆菌对米诺环素和头孢哌酮/舒巴坦的耐药率最低,对其他抗菌药物的耐药率均>60%。结论鲍曼不动杆菌的检出率较高,耐药性呈逐年上升趋势,应引起高度重视,对鲍曼不动杆菌进行规范的连续监测和耐药情况分析。

Objective To analyze the clinical infection and drug resistance of Acinetobacter baumannii in order to pro- vide a theoretical basis for clinical rational drug use. Methods A total of 228 strains of Acinetobac.ter baumannii iso- lated of hospitalized patients from January 2015 to December 2017 were selected for study. Vitek 2 compact automatic microbial identification and analysis system was used to identify strains, The specimens, distribution of departments, and drug resistance of Acinetobacter baumannii were analyzed. All data were statistically analyzed using WHONET5.4, a drug resistance monitoring soflware. Results A total of 228 strains of Acinetobac.ter baumannii were isolated. The de- tection rate was high in sputum specimens, wound secretions and urine, there were 154 strains accounted for 67.54%, 31 strains for 13.60%, and 14 strains for 6.14%. In the distribution of the department, there were 108 （47.37%） strains in the intensive care unit, followed by 36 （15.79%） strains in the respiratory medicine department. Acinetobac.ter bau- mannii had the lowest drug resistance to Minocycline and Cefoperazone/Sulbactam, but for other antimicrobial agents, the drug resistance rate was over 60%. Conclusion The detection rate of Acinetobac.ter baumannii is high, and the drug resistance is increasing year by year. It should be highly noted that standard continuous monitoring of Acinetobacter baumannii and the analysis of its drug resistance are performed.