2020—2022年某医院鲍曼不动杆菌临床感染特征及耐药趋势

Clinical infection characteristics and drug resistance trend of Acinetobacter baumannii in a hospital from 2020 to 2022

目的了解某医院鲍曼不动杆菌(Acinetobacter baumannii)临床分布特征及耐药情况,为临床合理用药和有效控制感染提供依据。方法收集某医院2020年1月—2022年12月临床标本分离的菌株,使用VitekⅡ全自动微生物分析仪进行常规鉴定及药敏试验。结果分离的1137株鲍曼不动杆菌主要分离自痰液,占84.61%;男性感染患者多于女性,≥65岁患者所占比例最高,占50.22%。主要分布在呼吸内科和重症监护病房,分别占19.26%和19.00%。鲍曼不动杆菌对测试的大多数抗菌药物耐药率>60%,对亚胺培南、美罗培南耐药率分别为63.07%~71.05%和65.14%~73.17%,对替加环素耐药率最低,为3.67%~6.10%。3年间对头孢他啶(65.24%~76.14%)、头孢呋辛(94.21%~97.05%)、头孢曲松(92.07%~98.12%)、亚胺培南(70.12%~71.05%)耐药率均有不同程度上升,对头孢哌酮/舒巴坦(71.04%~65.15%)、头孢吡肟(87.20%~66.22%)、头孢唑啉(95.12%~91.15%)、美罗培南(73.17%~68.10%)、左氧氟沙星(54.27%~42.09%)、阿米卡星(40.24%~23.06%)耐药率均有不同程度下降,差异有统计学意义(P<0.05)。结论鲍曼不动杆菌对抗菌药物耐药性严重,应加强细菌耐药监测,合理使用抗菌药物。

Objective To investigate the clinical distribution characteristics and drug resistance of Acinetobacter baumannii in a hospital,and to provide evidence for clinical medication and effective infection control.Methods The strains of isolated from clinical samples of a hospital from January 2020 to December 2022 were collected for routine identification and drug susceptibility test using VitekⅡautomatic microbial analyzer.Results The 1137 strains of Acinetobacter baumannii were mainly isolated from sputum,accounted for 84.61%.Male patients were more infected than female patients,and the proportion of patients≥65 years old was the highest,accounted for 50.22%.Acinetobacter baumannii strains were mainly distributed in the respiratory department and intensive care unit,accounted for 19.26%and 19.00%respectively.The resistance rate of Acinetobacter baumannii strains to most antibiotics tested was>60%.The resistance rates to imipenem and meropenem were 63.07%-71.05%and 65.14%-73.17%,respectively.The resistance rate to tigacycline was the lowest,ranged from 3.67%to 6.10%.The drug resistance rates to ceftazidime(65.24%-76.14%),cefuroxime(94.21%-97.05%),ceftriaxone(92.07%-98.12%)and imipenem(70.12%-71.05%)all increased during 3 years,while the drug resistance rates to cefoperazone/sulbactam(71.04%-65.15%),cefepime(87.20%-66.22%),cefazolin(95.12%-91.15%),meropenem(73.17%-68.10%),levofloxacin(54.27%-42.09%)and amicacin(40.24%-23.06%)all decreased.The difference was statistically significant(P<0.05).Conclusion The resistance of Acinetobacter baumannii was serious,the monitoring of bacterial resistance should be strengthened.Rational use of antibiotics should be adopted.