922株鲍曼不动杆菌的临床分布及其耐药特点分析

Clinical distribution and drug resistance of 922 strains of Acinetobacter baumannii

目的 探讨鲍曼不动杆菌(AB)的临床分布情况及其耐药特性,为临床防治提供依据。方法 回顾性分析本院2017年—2022年临床分离922株鲍曼不动杆菌的患者临床资料和药敏结果。结果 922株AB主要分离自痰液、创面和尿液,分别占51.6%、21.7%和10.5%;AB主要分布集中在重症医学科(40.3%)和烧伤科(17.1%),患者其年龄段主要分布在71岁~80岁、61岁~70岁、81岁~90岁和51岁~60岁,占比分别为24.5%、21.5%、16.1%和12.7%,各年龄段男性患者数均多于女性。不敏感率较低的3种药物为米诺环素、妥布霉素、庆大霉素,分别为11.7%、24.4%和30.6%,而氨曲南和呋喃妥因高达99.6%和100.0%;而对其余的抗菌药物均为在痰液中分离的AB的不敏感率高于创面分离的AB,而创面分离的AB不敏感率高于尿液分离的AB(P<0.01)。结论 AB临床分布广泛,以老年患者和男性患者居多,对多种抗菌药物的耐药性均较高;对大多数抗菌药物,在痰液中分离的AB的不敏感率较高。

Objective This paper aims to investigate the clinical distribution and drug resistance of Acinetobacter baumannii(AB), so as to provide evidence for clinical prevention and treatment. Methods Clinical data and drug sensitivity of 922 strains of AB isolated from Shaoxing Second Hospital from 2017 to 2022 were retrospectively analyzed. Results A total of 922 strains of AB were mainly isolated from sputum, wound and urine, accounting for 51.6%, 21.7% and 10.5%, respectively. AB was mainly distributed in intensive care department(40.3%) and burn department(17.1%). The patients were mainly distributed in 71-80 years old, 61-70 years old, 81-90 years old and 51-60 years old, accounting for 24.5%, 21.5%, 16.1% and 12.7%, respectively, and the number male patients was more than female patients in all age groups. The insensitivity rates of minocycline, tobramycin and gentamicin were low, which were 11.7%, 24.4% and 30.6% respectively, while that to amtreonam and furantoin were as high as 99.6% and 100.0%. The insensitivity rates to other antibacterial drugs of AB isolated from sputum were higher than that of AB isolated from wound, and the insensitivity rates of AB isolated from wound were higher than that of AB isolated from urine(P<0.01). Conclusion AB is widely distributed in clinic, mostly isolated from elderly patients and male patients, and it has high resistance to a variety of antibacterial drugs. AB isolated in sputum has a higher rate of insensitivity to most antibiotics.