贵州省少数民族地区某三甲医院ICU多药耐药鲍氏不动杆菌的流行病学特征

Epidemiological characteristics of multidrug-resistant Acinetobacter baumannii in ICU of a tertiary hospital in a minority area of Guizhou Province

目的调查某院重症监护病房(ICU)内多药耐药鲍氏不动杆菌(MDRAB)的流行情况以及实现连续耐药监控。方法收集某院2019年1月1日-2019年12月31日ICU临床分离的MDRAB,分析2019年多药耐药鲍氏不动杆菌季度检出情况,通过药敏试验分析其药敏谱。并应用流行病学与基因指纹试验(REP-PCR)进行同源性分析及流行病学调查。结果在某院ICU内100株MDRAB中,男性患者均高于女性患者(P<0.05),综合ICU内多为60岁以上患者(P<0.05);第三季度的MDRAB检出率最高(P<0.05);43%的MDRAB未及时下隔离医嘱;综合床位分布情况以及REP-PCR基因指纹分析技术,神外ICU分型较为集中的D型检出菌有3例患者于5~6月存在医院感染暴发情况。结论神外ICU存在MDRAB医院内感染的暴发流行,必须严格督查多重耐药菌防控措施的执行情况,REP-PCR基因指纹分析技术可以为医院内感染监测分析和控制该类耐药菌医院内感染的暴发流行提供重要的帮助。

OBJECTIVE To investigate the prevalence of multidrug resistant Acinetobacter baumannii(MDRAB)in intensive care unit(ICU)of the hospital.METHODS MDRAB was collected and isolated in the ICU from 1 Jan 2019 to 31 Dec 2019.The quarterly detection of multidrug resistant A.baumannii was calculated in 2019,and its drug sensitivity spectrum was analyzed by drug sensitivity test.Epidemiology and repetitive extragenic palindromic-polymerase chain reaction assay were used for homology analysis and epidemiological investigation.RESULTS Among patients in the ICU of the hospital which 100 strains of MDRAB isolated from,male patients were higher than female patients(P<0.05),and most patients in the comprehensive ICU were over 60 years old(P<0.05).The detection rate of MDRAB in the third quarter was the highest(P<0.05),and 43%of MDRABs were not quarantined in time.Comprehensive considering bed distribution and REP-PCR gene fingerprint analysis results,3 cases in the neurosurgery ICU detected with D-type bacteria was an outbreak of nosocomial infection between May and Jun.CONCLUSION There is an outbreak of MDRAB nosocomial infection in neurosurgery ICU,and the implementation of prevention and control measures of multidrug-resistant bacteria must be strictly monitored.REP-PCR gene fingerprinting analysis technology can provide important help for the monitoring and analysis of nosocomial infection and the control of the outbreak of nosocomial infection of such drug-resistant bacteria.