海南某医院多重耐药鲍曼不动杆菌的耐药性及其感染的危险因素

Drug resistance and risk factors of multi-drug resistant Acinetobacter baumannii infection in one hospital of Hainan

目的了解2018—2020年海南省儋州市某医院多重耐药鲍曼不动杆菌(MDRAB)的耐药性及其感染的危险因素。方法选取2018—2020年儋州市某医院583例鲍曼不动杆菌(AB)感染者为研究对象,根据药敏结果分为MDRAB组(245例)和非MDRAB组(338例),分析MDRAB对抗菌药物的耐药性。应用多因素Logistic回归分析MDRAB感染的危险因素。结果药敏结果显示,MDRAB对多黏菌素(93.88%)的敏感率较高,对头孢曲松、头孢吡肟、亚胺培南、环丙沙星和呋喃妥因的耐药率均为100.00%。多因素Logistic回归分析显示,糖尿病史(OR=1.583,95%CI:1.164~2.175)、使用切口引流管(OR=2.158,95%CI:1.372~3.806)、支气管镜检(OR=2.638,95%CI:1.575~4.117)及使用碳青霉烯类抗菌药物(OR=3.416,95%CI:2.635~6.903)是MDRAB感染的危险因素。结论该院MDRAB对多种抗菌药物耐药,且耐药率较高,糖尿病史、使用引流管、支气管镜检及使用碳青霉烯类抗菌药物是其感染的危险因素。

Objective To understand the drug resistance and risk factors of infection of multi-drug resistant Acinetobacter baumannii(MDRAB)in one hospital in Danzhou,Hainan from 2018 to 2020.Methods A total of 583 patients with Acinetobacter baumannii(AB)infection in a hospital of Danzhou from 2018 to 2020 were selected as the study objects.According to the drug sensitivity results,they were divided into MDRAB group(245 patients)and non-MDRAB group(338 patients).The drug resistance of MDRAB was analyzed.Multiple Logistic regression was used to analyze the risk factors of MDRAB infection.Results The results showed that MDRAB was highly susceptible to polymyxin(93.88%),while it had 100.00%resistance to ceftriaxone,cefepime,imipenem,ciprofloxacin and furantoin.Multivariate Logistic regression analysis showed that history of diabetes mellitus(OR=1.583,95%CI:1.164-2.175),use of incision drainage tube(OR=2.158,95%CI:1.372-3.806),bronchoscopy(OR=2.638,95%CI:1.575-4.117),and use of carbapenems(OR=3.416,95%CI:2.635-6.903)were risk factors of MDRAB infection.Conclusions The strains of MDRAB isolated from this hospital are resistant to several antibiotics with high resistance rate.History of diabetes mellitus,use of incision drainage tube,bronchoscopy and use of carbapenems are risk factors of MDRAB infection.