2012～2016年鲍曼不动杆菌分布及耐药变化趋势分析
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摘要
目的对2012~2016年医院患者鲍曼不动杆菌(AB)感染现状及耐药性进行调查,为感染监控和临床用药提供参考。方法回顾性分析2012~2016年医院患者细菌培养标本中AB的分离情况及耐药性的变迁趋势。结果 2012~2016年临床共分离AB 2 168株,分离率2012~2014年逐年上升,而2014~2016年则呈逐年下降趋势,临床分离的AB主要来源于痰标本,分离AB阳性率较高的病区是重症医学科、神经外科、呼吸科、老年病科和骨科等,AB对大多数抗菌药物的耐药率>70%,耐药率最低的是头孢哌酮/舒巴坦,2012~2016年AB的多重耐药率呈逐年上升趋势。结论虽然本院的鲍曼不动杆菌临床分离率有下降趋势,但多重耐药率仍逐年上升,说明鲍曼不动杆菌的耐药形势严峻,需引起各相关科室高度重视,临床应根据药物敏感性试验结果合理使用抗菌药物。
Objective To investigate the current epidemic situation of hospital infection of Acinetobacter baumannii and its resistance to antibiotics in order to provide reference for clinical treatments.Methods The retrospective analyses were performed based on the sample isolations and bacterial cultures from inpatients in the hospital from 2012 to 2016.Results A total of 2168 bacterial strains were collected. The positive rate was found to annually increase from 2012 to 2014 but it showed a gradual decrease from 2014 to 2016. Clinical isolates of A. baumannii were mainly from sputum samples. The majority of isolates came from the critical care medicine,neurosurgery,pulmonary infections,orthopedics,and geriatrics. The resistance rate of A. baumannii to antibiotics that are currently used was as high as 70 percent. The bacterial resistance to Cefoperazone was the lowest of all isolates. Conclusion The frequency of multiple drug resistance seems to be rising in spite of the decreased A.baumannii isolation in the hospital surveyed,indicating an urgent need of clinician use of antibiotics based on sensitivity test.
Objective To investigate the current epidemic situation of hospital infection of Acinetobacter baumannii and its resistance to antibiotics in order to provide reference for clinical treatments.Methods The retrospective analyses were performed based on the sample isolations and bacterial cultures from inpatients in the hospital from 2012 to 2016.Results A total of 2168 bacterial strains were collected. The positive rate was found to annually increase from 2012 to 2014 but it showed a gradual decrease from 2014 to 2016. Clinical isolates of A. baumannii were mainly from sputum samples. The majority of isolates came from the critical care medicine,neurosurgery,pulmonary infections,orthopedics,and geriatrics. The resistance rate of A. baumannii to antibiotics that are currently used was as high as 70 percent. The bacterial resistance to Cefoperazone was the lowest of all isolates. Conclusion The frequency of multiple drug resistance seems to be rising in spite of the decreased A.baumannii isolation in the hospital surveyed,indicating an urgent need of clinician use of antibiotics based on sensitivity test.
引文
1徐一鸣,王蓓,蒋晓飞.2008至2012年鲍曼不动杆菌临床感染分布及耐药特征分析[J].检验医学,2014,29(3):245-248.
2 DURANTE-MANGONI E,ZARRILLI R.Global spread of drug-resistant Acinetobacter baumannii:molecular epidemiology and management of antimicrobial resistance[J].Future microbiology,2011,6(4):407-422.
3 冯小玲,陈红梅.广安地区多重耐药鲍曼不动杆菌的临床分布及耐药分析[J].中外医疗,2014,(17):124-125.
4 FALAGAS M E,KOLETSI P K,BLIZIOTIS I A.The diversity of definitions of multidrug-resistant(MDR)and pandrug-resistant(PDR)Acinetobacter baumannii and Pseudomonas aeruginosa[J].Journal of medical microbiology,2006,55(Pt 12):1619-1629.
5 CHAN M C,CHIU S K,HSUEH P R,et al.Risk factors for healthcare-associated extensively drugresistant Acinetobacter baumannii infections:a casecontrol study[J].Plo S one,2014,9(1):e85973.
6 赵凤容,陆水英,张秀渝,等.多重耐药鲍曼不动杆菌感染危险因素分析[J].检验医学与临床,2014,11(10):1310-1312.
7 李文青,吴伟元,卢月梅,等.连续11年深圳地区鲍曼不动杆菌感染的临床分布及耐药趋势分析[J].中国微生态学杂志,2013,25(6):667-670.
8 胡付品.2015年CHINET细菌耐药性监测[J].中国感染与化疗杂志,2016,06(16):685-694.
9 VILA J,MARTI S,SANCHEZ-CESPEDES J.Porins,effluxpumps and multi drug resistance in Acinetobacter baumannii[J].The Journal of antimicrobial chemotherapy,2007,59(6):1210-1215.
10 GORDONNC,WAREHAMD W.Multidru gresistant Acinetobacter baumannii:mechanisms of virulence and resistance[J].International journal of antimicrobial agents,2010,35(3):219-226.
11 陈川,范红,罗岚,等.2006-2010年华西医院鲍曼不动杆菌的耐药趋势分析[J].中国抗生素杂志,2012,37(5):352-356.
12 陈丽慧,申彩云.鲍曼不动杆菌的临床分布及耐药情况的分析[J].中国医药指南,2014,12(20):127-128.
13 范学财,王勇,王晓红,等.2012~2013年某院鲍曼不动杆菌的分布及耐药情况分析[J].国际检验医学杂志,2014,35(16):2192-2193.
2 DURANTE-MANGONI E,ZARRILLI R.Global spread of drug-resistant Acinetobacter baumannii:molecular epidemiology and management of antimicrobial resistance[J].Future microbiology,2011,6(4):407-422.
3 冯小玲,陈红梅.广安地区多重耐药鲍曼不动杆菌的临床分布及耐药分析[J].中外医疗,2014,(17):124-125.
4 FALAGAS M E,KOLETSI P K,BLIZIOTIS I A.The diversity of definitions of multidrug-resistant(MDR)and pandrug-resistant(PDR)Acinetobacter baumannii and Pseudomonas aeruginosa[J].Journal of medical microbiology,2006,55(Pt 12):1619-1629.
5 CHAN M C,CHIU S K,HSUEH P R,et al.Risk factors for healthcare-associated extensively drugresistant Acinetobacter baumannii infections:a casecontrol study[J].Plo S one,2014,9(1):e85973.
6 赵凤容,陆水英,张秀渝,等.多重耐药鲍曼不动杆菌感染危险因素分析[J].检验医学与临床,2014,11(10):1310-1312.
7 李文青,吴伟元,卢月梅,等.连续11年深圳地区鲍曼不动杆菌感染的临床分布及耐药趋势分析[J].中国微生态学杂志,2013,25(6):667-670.
8 胡付品.2015年CHINET细菌耐药性监测[J].中国感染与化疗杂志,2016,06(16):685-694.
9 VILA J,MARTI S,SANCHEZ-CESPEDES J.Porins,effluxpumps and multi drug resistance in Acinetobacter baumannii[J].The Journal of antimicrobial chemotherapy,2007,59(6):1210-1215.
10 GORDONNC,WAREHAMD W.Multidru gresistant Acinetobacter baumannii:mechanisms of virulence and resistance[J].International journal of antimicrobial agents,2010,35(3):219-226.
11 陈川,范红,罗岚,等.2006-2010年华西医院鲍曼不动杆菌的耐药趋势分析[J].中国抗生素杂志,2012,37(5):352-356.
12 陈丽慧,申彩云.鲍曼不动杆菌的临床分布及耐药情况的分析[J].中国医药指南,2014,12(20):127-128.
13 范学财,王勇,王晓红,等.2012~2013年某院鲍曼不动杆菌的分布及耐药情况分析[J].国际检验医学杂志,2014,35(16):2192-2193.