鲍曼不动杆菌的流行现状、临床分布和耐药性分析

An analysis of epidemic status,clinical distribution and medicines resistance of acinetobacter baumannii

目的:对2019年1-12月枣庄市立医院住院患者鲍曼不动杆菌的流行现状、临床分布及耐药情况进行分析,为临床治疗鲍曼不动杆菌感染及合理使用抗菌药物提供参考依据。方法:针对本院2019年1-12月分离出的806株鲍曼不动杆菌进行回顾性分析。采用德国布鲁克质谱仪进行细菌鉴定、VITEK-2 Compact全自动微生物鉴定药敏分析仪进行药敏试验,采用K-B法做头胞哌酮/舒巴坦、阿米卡星、哌拉西林/他唑巴坦、米诺环素体外药敏试验。结果:806株鲍曼不动杆菌的标本类型主要包括痰液、肺泡灌洗液、伤口分泌物。送检科室主要为内科重症加强护理病房(Intensive Care Unit,ICU)、中心ICU、急诊ICU、呼吸科。2019年耐药数据显示:除左氧氟沙星、阿米卡星、米诺环素的耐药率外,对其他几种抗菌药物的耐药率都大于80%。结论:我院分离出的多重耐药鲍曼不动杆菌菌株比例较高,部位以下呼吸道多见,该菌对抗生素耐药形势严峻,应了解鲍曼不动杆菌的流行现状、临床分布及耐药性,定期分析多重耐药鲍曼不动杆菌的检出率的变化和耐药趋势,为临床和院感科提供有用的数据和结果,指导临床合理选用抗菌药物。

Objective:The epidemic status,clinical distribution and medicine resistance of acinetobacter baumannii in the hospital from January 2019 to December 2019 was analyzed in order to provide reference for clinical treatment of acinetobacter baumannii infection and the rational application of antimicrobial medicines.Methods:806 acinetobacter baumannii strains isolated were retrospectively analyzed.The Germany Bruker mass spectrometry for bacterial identification and VITEK-2 Compact automatic microbiological identification medicine sensitivity analyzer were applied.The in vitro susceptibility testing of cefoperazone/sulbactam,amikacin,piperacillin/tazobactam and minocycline were performed by K-B method.Results:The specimen types of 806 strains of acinetobacter baumannii mainly included sputum,alveolar lavage fluid and wound secretions.The examination departments were mainly internal ICU,central ICU,urgent ICU and respiratory department.According to medicine resistance data in 2019,the resistance of levofloxacin,amikacin,minocycline,the resistance rate of several other antimicrobial medicines was greater than 80%.Conclusion:The proportion of multiple medicine resistant acinetobacter baumannii strains isolated in our hospital is relatively higher,and the detected parts are more common in the lower respiratory tract.The situation of antibiotic resistance of this bacterium is severe.It is necessary to understand the epidemic situation,clinical distribution and medicine resistance of acinetobacter baumannii,and regularly analyze the detection change and the trend of medicine resistance of multiple medicine resistant acinetobacter baumannii strains,in order to provide useful data and results for clinic,and guide clinical rational application of antimicrobial agents.