2018-2022年某院鲍曼不动杆菌的临床分布情况及耐药性分析

Clinical distribution and drug resistance analysis of Acinetobacter baumannii in a hospital from 2018 to 2022

目的分析患者鲍曼不动杆菌感染情况及耐药特点,为临床合理使用抗生素和防止院内感染提供参考依据。方法回顾性分析2018年1月-2022年12月鄂尔多斯市中心医院门诊及住院患者送检细菌培养标本中鲍曼不动杆菌的分离情况及耐药性。结果2018-2022年共收集临床分离菌株14027株,其中分离出鲍曼不动杆菌864株,检出率为6.16%(864/14027)。鲍曼不动杆菌中检出耐碳青霉烯类鲍曼不动杆菌(CRAB)407株,占47.11%(407/864);碳青霉烯类敏感鲍曼不动杆菌(CSAB)457株,占52.89%(457/864)。鲍曼不动杆菌主要分离标本以痰液为主,占90.05%(778/864);主要分离科室为重症监护病房(ICU)占33.33%(288/864),其次为呼吸内科占16.09%(139/864)。被检测的14种抗生素中,鲍曼不动杆菌耐药率最高的抗生素是哌拉西林/他唑巴坦占54.04%,其次为环丙沙星(50.64%)、替卡西林/克拉维酸(47.51%)和左旋氧氟沙星(45.81%);CRAB耐药率最高的抗生素是哌拉西林/他唑巴坦和替卡西林/克拉维酸,均为100.00%,其次为环丙沙星(99.74%)、左旋氧氟沙星(89.42%)和妥布霉素(88.50%)。CSAB耐药率最高的抗生素是复方磺胺甲唑占6.50%,其次为环丙沙星(6.40%)、左旋氧氟沙星(6.10%)和哌拉西林/他唑巴坦(5.80%)。鲍曼不动杆菌、CRAB和CSAB均未发现对多粘菌素、头孢哌酮/舒巴坦和替加环素的耐药菌株,对这3种抗生素敏感率均为100.00%。结论鲍曼不动杆菌对多种抗生素耐药严重,特别是CRAB耐药性更为严重,应当合理、规范使用抗生素,抑制耐药菌株的产生,为临床感染防控提供科学的参考依据。

Objective The infection of Acinetobacter baumannii and its resistance characteristics were analyzed to provide reference for rational clinical use of antibiotics and prevent nosocomial infection.Methods Acinetobacter baumannii was isolated from outpatient and inpatient bacterial culture samples and drug resistance was analyzed from 2018 to 2022.Results From 2018 to 2022,a total of 14027 clinical isolates were collected,among which 864 Acinetobacter baumannii were isolated,with a detection rate of 6.16%(864/14027).A total of 407 carbapenem⁃resistant Acinetobacter baumannii(CRAB)strains were detected,accounting for 47.11%(407/864),and 457 carbapenem⁃susceptible Acinetobacter baumannii(CSAB)strains,accounting for 52.89%(457/864).The main isolated samples of Acinetobacter baumannii were mainly sputum,accounting for 90.05%(778/864).The main department which Acinetobacter baumannii was isolated was the intensive care unit(ICU),accounting for 33.33%(288/864),followed by respiratory medicine,accounting for 16.09%(139/864).Of the 14 antibiotics tested,the highest Acinetobacter baumannii resistance were piperacillin/tazobactam(54.04%),followed by ciprofloxacin(50.64%),ticab/clavulanate(47.51%)and levofloxacin(45.81%);CRAB resistance was pib/tazobactam/clavulanate,both 100.00%,followed by ciprofloxacin(99.74%),levofloxacin(89.42%)and tobramycin(88.50%).The antimicrobial agents with the highest resistance to CSAB were compound sulfamethoazole(6.50%),followed by ciprofloxacin(6.40%),levofloxacin(6.10%),and piperacillin/tazobactam(5.80%).Acinetobacter baumannii,CRAB,and CSAB were not resistant to polymyxin,cefoperazone/sulbactam,and tigecycline,which showed 100.00%susceptible to all three antimicrobial agents.Conclusion Acinetobacter baumannii had serious resistance to a variety of antimicrobial drugs,especially CRAB,which should be used and standardized to inhibit the production of drug⁃resistant strains and provide scientific reference basis for clinical infection prevention and control.