甘肃地区多重耐药鲍曼不动杆菌临床分离株的分布及耐药性

Distribution and antimicrobial resistance profile of multidrug-resistant Acinetobacter baumannii in Gansu region

目的了解甘肃地区多重耐药鲍曼不动杆菌的分布和耐药情况,促进临床合理使用抗菌药物。方法采用WHONET 5.6软件,分析2019年甘肃地区74所医院多重耐药鲍曼不动杆菌的分离、分布及药敏结果。结果2019年甘肃地区检出鲍曼不动杆菌3389株,占总菌株的4.76%,检出多重耐药鲍曼不动杆菌2493株,检出率3.50%,占所有检出鲍曼不动杆菌的73.56%。多重耐药鲍曼不动杆菌主要分离自呼吸道标本,其次为分泌物、血液、尿液标本,分别为81.31%、4.25%、2.85%和2.05%;科室分布以重症监护室(ICU)、神经外科、呼吸科和神经内科为主,分别为43.80%、15.56%、9.43%和7.02%;菌株检出患者年龄分布以51~60岁最多,为619例(24.83%);药敏结果显示鲍曼不动杆菌对13种常用抗菌药物的耐药率普遍较高,对其中8种抗菌药物的耐药率超过90%。结论甘肃地区多重耐药鲍曼不动杆菌的检出率及耐药问题已非常严峻,需及时掌握鲍曼不动杆菌的耐药动态,督促临床合理使用抗菌药物。

Objective To understand the distribution and antimicrobial resistance profile of multidrug-resistant Acinetobacter baumannii in Gansu region,and promote more reasonable clinical use of antibacterial agents.Methods WHONET 5.6 software was used to analyze the data regarding the distribution and antimicrobial susceptibility results of multi-drug resistant A.baumannii isolated from 74 hospitals across Gansu in 2019.Results In 2019,3389 strains of A.baumannii were detected in Gansu,accounting for 4.76%of the total bacterial isolates.The prevalence of multidrug-resistant A.baumannii was 73.56%(2493/3389).Multidrug resistant A.baumannii strains were mainly isolated from respiratory tract specimens,followed by secretions,blood,and urine specimens,accounting for 81.31%,4.25%,2.85%,and 2.05%,respectively.The multidrug-resistant A.baumannii strains were mainly isolated from intensive care unit(ICU),neurosurgery,respiratory department,and neurology,accounting for 43.80%,15.56%,9.43%,and 7.02%,respectively.The multidrug-resistant A.baumannii strains were mostly prevalent in the patients of 51-60 years old(24.83%,619/2493).Antimicrobial susceptibility testing showed that the multidrug-resistant A.baumannii strains were highly resistant to 13 commonly used antibacterial agents.More than 90%of these strains were resistant to 8 of the 13 drugs tested.Conclusions The prevalence and resistance levels of multidrug-resistant A.baumannii have become a very serious issue in Gansu.It is necessary to know the changing susceptibility profile of A.baumannii in time and encourage the rational use of antibiotics in clinical practice.