某医院多重耐药鲍曼不动杆菌的临床分布情况分析

Analysis of clinical distribution of multidrug-resistant Acinetobacter baumannii in a hospital

目的了解医院感染多重耐药鲍曼不动杆菌(MDR-AB)的临床分布情况,为临床合理用药和医院感染控制提供参考。方法回顾性研究2016—2019年某医院住院患者分离的鲍曼不动杆菌耐药率,分析MDR-AB的检出情况及临床分布。结果临床分离的鲍曼不动杆菌对常用抗菌药物普遍耐药,耐药率大多超过50%,对头孢他啶、头孢吡肟、氨苄西林舒巴坦、哌拉西林他唑巴坦、左氧氟沙星、环丙沙星、复方新诺明、美罗培南和亚胺培南等抗菌药物耐药率均达75%以上,仅对美满霉素和多黏菌素B较敏感。共分离出MDR-AB 850株,主要来源于社区获得性感染,占87.29%;MDR-AB主要分离自呼吸道,占89.18%;MDR-AB检出科室居前3位的依次为重症监护室(ICU)、呼吸内科和神经外科。结论该院鲍曼不动杆菌耐药情况严重,MDR-AB检出率较高,主要为呼吸道感染,以ICU和呼吸内科为主,应规范临床合理用药,降低MDR-AB感染率,做好重点科室的耐药监测工作。

Objective To understand the clinical distribution of multidrug-resistant Acinetobacter baumannii(MDR-AB)in nosocomial infections,and to provide references for clinical rational drug use and nosocomial infection control.Methods The drug resistance rates of Acinetobacter baumannii isolated from inpatients in a hospital from 2016 to 2019 were retrospectively studied,and the detection and clinical distribution of MDR-AB were analyzed.Results The clinically isolated Acinetobacter baumannii were generally resistant to commonly used antibacterial drugs,and the drug resistance rates were mostly more than 50%.The drug resistance rates to ceftazidime,cefepime,ampicillin and sulbactam,piperacillin and tazobactam,levofloxacin,ciprofloxacin,compound trimethoprim,meropenem,and imipenem were all more than 75%,and they were only sensitive to minocycline and polymyxin B.A total of 850 strains of MDR-AB were isolated,mainly from community-acquired infections,accounting for 87.29%;MDR-AB were mainly isolated from respiratory tract,accounting for 89.18%;the top 3 departments of MDR-AB detection were intensive care unit(ICU),respiratory medicine and neurosurgery.Conclusion The drug resistance of Acinetobacter baumannii in this hospital is serious,and the detection rate of MDRAB is relatively high.The main cause is respiratory tract infection,and MDR-AB detection are mainly from ICU and respiratory medicine department.The clinical rational use of drugs should be standardized to reduce the MDR-AB infection rate,and drug resistance in key departments should be monitored well.