耐碳青霉烯鲍曼不动杆菌感染的流行病学研究

Epidemiological characteristics of carbapenems-resistant Acinetobacter baumanii

目的探讨我院耐碳青霉烯鲍曼不动杆菌(CRAB)感染的流行病学特征。方法收集我院2016年1月至2019年12月CRAB感染患者的临床资料,对CRAB的检出情况、标本来源、病区分布等进行统计分析。结果共分离出CRAB 386株,CRAB在临床分离的致病菌株中所占比例逐年上升;易感人群主要为中老年人;标本来源以呼吸道标本(痰液和肺泡灌洗液)为主,呼吸重症监护室和重症监护室检出率最高,分别为30.89%和23.98%。CRAB感染患者的死亡率为38.42%,显著高于碳青霉烯敏感鲍曼不动杆菌(CSAB)感染患者(21.64%,P<0.05)。结论CRAB是医院内感染的重要病原菌,临床检出率呈上升趋势,主要涉及重症监护室,尤其是呼吸重症监护室。院感防控工作应关注易感人群及重点科室,有效遏制医院内感染的爆发和蔓延。

Objective To explore the epidemiological characteristics of carbapenem-resistant Acinetobacter baumannii(CRAB)in our hospital.Methods The clinical data of CRAB in our hospital from 2016 to 2019 were collected,and the results of CRAB detection,specimen source,and department distribution were analyzed.Results A total of 386 strains of CRAB were detected,and the proportion of CRAB in pathogenic bacteria isolated in clinical practice increased gradually over time.The majority of CRAB infections occurred in elderly patients;the patients involved were mainly in the respiratory intensive care unit(30.89%)and the general intensive care unit(23.98%).The main site of CRAB infection was the respiratory system.The mortality rate in the patients infected with CRAB was 38.42%,which was significantly higher than that in the patients infected with carbapenems-susceptible Acinetobacter baumannii(CSAB)(21.64%,P<0.05).Conclusion The rates of isolation and infection of CRAB are gradually increasing,and CRAB has become one of the main pathogens that causes nosocomial infections.The mortality rate due to CRAB infection was much higher than that due to CSAB infection;therefore,to protect the susceptible population in the ICU,measures should be taken to control CRAB infections and prevent outbreaks.