耐碳青霉烯类鲍曼不动杆菌耐药特性分析

Analysis of drug-resistant properties of the carbonapenem-resistant Acinetobacter baumannii

目的分析耐碳青霉烯类鲍曼不动杆菌(CRAB)的耐药特性及分布情况。方法选择2019年1月至2020年7月在我院检测出鲍曼不动杆菌(AB)感染的230例患者为研究对象,依据是否为CRAB感染将其分为两组:76例CRAB感染的患者为耐碳青霉烯类组,154例非CRAB感染的患者为非耐碳青霉烯类组。比较两组的耐药特性,并分析CRAB的分布与来源。结果耐碳青霉烯类组对抗菌药物的耐药特性明显高于非耐碳青霉烯类组,差异具有统计学意义(P<0.05);耐碳青霉烯类组对其他10种抗菌药物的耐药性均高于92.25%,但其对阿米卡星耐药率为26.92%;非耐碳青霉烯类组对本次试验的抗菌药物的耐药性均低于23.51%。44.74%的CRAB分布于ICU,15.79%分布于神经内科;标本的主要来源为痰液,占比为81.58%,其他来源均未超过10.00%。结论CRAB的耐药性较高,金属β-内酰胺酶是CRAB产生耐药的主要原因,医院应增强对AB耐药性的重视,加强院内的消毒与患者之间的隔离,防止造成院内大范围的感染,降低院内感染率与患者死亡率。

Objective To analyze the drug-resistant properties and distribution of the carbonapenem-resistant Acinetobacter baumannii(CRAB).Methods A total of 230 patients with Acinetobacter baumannii(AB)infection detected in our hospital from January 2019 to July 2020 were selected as the research objects.According to whether the patients had CRAB infection,the patients were divided into two groups:76 patients with CRAB infection were carbapenem-resistant group,and 154 patients with non CRAB infection were non carbapenem-resistant group.The drug-resistant properties of the two groups were compared and the distribution and sources of CRAB were analyzed.Results The drug-resistant properties of the drug-resistant of the carbapenem-resistant group was significantly higher than that of the non carbapenem-resistant group,and the difference was statistically significant(P<0.05);the drug-resistance rate of the drug-resistant of the carbapenem-resistant group to other 10 antibiotics was higher than 92.25%,but the drug-resistance rate to amikacin was 26.92%;the antimicrobial resistance of the drug-resistant of the non carbapenem-resistant group in this experiment was lower than 23.51%.CRAB of 44.74%was distributed in ICU and 15.79%in neurology department;the main source of specimens was sputum,accounting for 81.58%,and other sources were less than 10.00%.Conclusion The drug-resistance properties of CRAB is relatively higher,and metallo-β-lactamases is the main reason for the drug resistance of CRAB.The hospital should pay more attention to the drug-resistance of AB,strengthen the disinfection in the hospital and the isolation between patients,so as to prevent the large-scale infection in the hospital and reduce the hospital infection rate and mortality of patients.