某医院耐碳青霉烯鲍曼不动杆菌感染调查及耐药性监测

Survey of Carbapenem Resistant Acinetobacter baumannii Infection and Drug Resistance Surveillance in a Hospital

目的对某医院2016年—2019年耐碳青霉烯鲍曼不动杆菌(CRAB)的感染趋势及耐药性进行分析,为抗菌药物的合理使用提供参考。方法收集某综合医院2016年—2019年CRAB临床资料,对CRAB的检出情况、标本来源、病区分布和药敏结果等进行统计分析。结果共收集到鲍曼不动杆菌292株,其中CRAB有68株,检出率为23.3%,检出率呈上升趋势(x2﹦11.81,P<0.01)。CRAB标本来源以痰液为主,占80.9%,不同病区之间CRAB的检出率具有差异,ICU检出率最高,占72.6%,其次是神经外科和呼吸内科,分别为31.8%、19.0%,儿科检出率最低,为2.4%,ICU病区检出率显著高于非ICU病区(x2﹦107.06,P<0.01)。CRAB对抗菌药物的耐药性显著高于非CRAB(P均<0.01),对头孢曲松、头孢他啶、头孢吡肟、庆大霉素和环丙沙星的耐药率>80.0%,对替加环素的耐药率最低,为27.9%。结论该医院CRAB的检出率呈上升趋势,CRAB对临床常用抗菌药物呈现广泛耐药,应加强CRAB感染的监控及耐药性监测,根据药敏结果合理选用抗菌药物。

Objective To analyze the infection trend drug resistance of carbapenem-resistant Acinetobacter baumannii(CRAB)in a hospital from 2016 to 2019,it provide the reference for the rational use of antibacterial.Methods The clinical data of CRAB in a general hospital from 2016 to 2019 were collectde and the results of CRAB detection,specimen source,distribution of disease area and drug sensitivity were analyze statistically.Results There were 292 strains of Acinetobacter baumannii collected,of which 68 strains were CRAB,the detection rate was 23.3%,the detection rate showed an upward trend(x2﹦11.81,P<0.01).The source of the CRAB specimens was mainly Sputum,accounting for 80.9%.The detection rate of CRAB between different wards was different,The highest rate was in ICU(72.6%),followed by neurosurgery and respiratory medicine,which were 31.8%and 19.0%,respectively.The pediatric detection rate was the lowest,which was 2.4%,the detection rate in ICU ward was signifcantly higher than in non-ICU ward(x2﹦107.06,P<0.01).The resistance rate of CRAB antibacterials was significantly higher than non-CRAB(all P<0.01).The resistance rate of ceftriaxone,ceftazidime,cefepime,gentamicin,and ciprofoxacin was more than 80.0%,the resistance rate of Tigecycline was the lowest(27.9%).Conclusion The detection rate of CRAB in this hospital is on the rise,and the CRAB is extensively resistant to commonly used antibacterial in clinical.It is necessary to strengthen the conteol of CRAB infection and the monitoring of drug resistance,according to the rational use of antibiotics susceptibility results.