2016-2018年禅城区中心医院鲍曼不动杆菌的临床分布及耐药性分析

Clinical distribution and drug resistance analysis of Acinetobacter baumannii in the central hospital of chancheng district from 2016 to 2018

目的探讨该院鲍曼不动杆菌的临床分布特点和对抗菌药物的抗菌活性,预测药物的抗感染效果,为降低医院感染提供参考数据。方法回顾性分析2016-2018年该院检出的鲍曼不动杆菌的临床分布特征及耐药率。结果2016-2018年检出655株鲍曼不动杆菌,在临床分离的致病菌株中占比逐年上升,检出率分别为1.58%、2.04%、3.67%;痰液(77.4%)是检出比例最高的标本类型,其次为尿液(9.6%)和分泌物(6.7%);临床科室检出鲍曼不动杆菌占比较大为重症监护病房(44.0%)、呼吸内科(19.5%)和神经外科(12.5%)。2016-2018年鲍曼不动杆菌对抗菌药物的耐药性呈下降趋势,除头孢哌酮/舒巴坦、复方磺胺甲噁唑对抗感染较敏感外,对其余抗菌药物均有较高的耐药性;重症监护病房分离的鲍曼不动杆菌对抗菌药物有较高的耐药性,而普儿科和呼吸内科培养的鲍曼不动杆菌对抗菌药物有较好的敏感性,耐碳青霉烯类鲍曼不动杆菌检出率有所升高。结论鲍曼不动杆菌临床检出率逐渐上升,对抗菌药物有广泛耐药性,且耐药性强。不同科室耐药性有差别,临床应加强无菌操作意识,抗感染治疗首选敏感抗菌药物。

Objective To investigate the clinical distribution characteristics and antibacterial activity of Acinetobacter baumannii in hospital,to predict the anti-infective effect of the drug,and to provide reference data for reducing nosocomial infections.Methods A retrospective statistical analysis was performed on the clinical distribution and drug resistance rate of Acinetobacter baumannii detected from 2016 to 2018 in the hospital.Results A total of 655 strains of Acinetobacter baumannii were detected from 2016 to 2018,and the proportion of pathogenic bacteria isolated in clinical practice increased year by year,with the detection rates of 1.58%,2.04%and 3.67%,respectively;sputum(77.4%)was the sample type with the highest detection rate,followed by urine(9.6%)and secretion(6.7%);the most common pathogens detected in clinical departments were ICU(44.0%),respiratory medicine(19.5%)and neurosurgery(12.5%).The resistance of Acinetobacter baumannii to antibacterial drugs showed a downward trend from 2016 to 2018.In addition to cefoperazone/sulbactam and compound sulfamethoxazole,they had higher resistance to other antibacterial drugs;the Acinetobacter baumannii isolated from ICU had a high resistance rate to antimicrobial drugs,while the Acinetobacter baumannii cultured in department of general pediatrics and respiratory medicine had good sensitivity to antimicrobial drugs,and the detection rate of carbapenem-resistant Acinetobacter baumannii had increased.Conclusion The clinical detection rate of Acinetobacter baumannii is gradually increasing,and it has extensive resistance to antibacterial drugs,and strong resistance.Different departments have different drug resistance,clinical consciousness of aseptic operation should be strengthened,the first principle of anti-infective treatment is sensitive antibacterial drugs.