摘要
目的:探讨鲍曼不动杆菌院内感染的分布特点及耐药性。方法:选取2020年5月至2021年7月期间在湘潭市中心医院接受治疗的鲍曼不动杆菌院内感染患者182例作为研究对象。收集这些患者的临床资料、细菌培养与鉴定结果,统计其标本来源。对标本分布科室进行汇总,并分析分离出菌株的耐药性情况。结果:182例鲍曼不动杆菌院内感染标本的主要来源科室为重症监护室,其占比(46.15%)显著高于呼吸内科、骨外科、神经外科、肿瘤内科、泌尿外科及其他科室,差异具有统计学意义(P<0.05)。药敏试验显示,182例患者分离出的鲍曼不动杆菌菌株对复方磺胺甲恶唑的耐药率(18.68%)最低,显著低于氨苄西林/舒巴坦(59.89%)、派拉西林/他唑巴坦(58.79%)、阿莫西林/克拉维酸(57.69%)、替卡西林/克拉维酸(56.04%)、庆大霉素(58.24%)、妥布霉素(57.14%)、环丙沙星(57.69%)、奈替米星(55.49%)、左氧氟沙星(52.20%)、头孢吡肟(47.80%)、头孢他啶(46.70%)、头孢噻肟(45.60%)、亚胺培南(37.36%)、阿米卡星(34.06%),差异具有统计学意义(P<0.05)。结论:重症监护室、呼吸内科等科室是鲍曼不动杆菌院内感染的高发科室,鲍曼不动杆菌院内感染常存在对多种抗菌药物耐药的问题,临床上需根据药敏试验结果选择合理的抗菌药物进行相关治疗,以保证抗菌效果。
Objective:To investigate the distribution characteristics and drug resistance of nosocomial infection of Acinetobacter baumannii.Methods:A total of 182 patients with nosocomial acinetobacter baumannii infection who were treated in Xiangtan Central Hospital from May 2020 to July 2021 were selected as subjects.The clinical data,bacterial culture and identification results of these patients were collected,and the sources of their specimens were counted.The specimen distribution departments were summarized,and the drug resistance of isolated strains was analyzed.Results:The main source of 182 nosocomial infection specimens of ACinetobacter baumannii was intensive care unit,and the proportion(46.15%)was significantly higher than that of respiratory medicine,orthopedics,neurosurgery,oncology,urology and other departments,with statistical significance(P<0.05).Drug sensitivity test showed that acinetobacter baumannii isolated from 182 patients had the lowest drug resistance rate to compound sulfamethoxazole(18.68%).Significantly lower than that of ampicillin/sulbactam(59.89%),piracillin/tazobactam(58.79%),amoxicillin/clavulanic acid(57.69%),ticacillin/clavulanic acid(56.04%),gentamicin(58.24%),tobramycin(57.14%),ciprofloxacin(57.69%),netimicin(55.49%),levofloxacin(52.20%),cefepime(47.80%),ceftazidime(46.70%),cefotaxime(45.60%),imipenem(37.36%),amikacin(34.06%),the differences were statistically significant(P<0.05).Conclusion:Intensive care unit,respiratory department and other departments are the departments with high incidence of nosocomial infection of ACinetobacter baumannii.The nosocomial infection of ACinetobacter baumannii often has the problem of drug resistance to a variety of antibacterial drugs.In clinical practice,reasonable antibacterial drugs should be selected for relevant treatment according to the results of drug sensitivity test to ensure antibacterial effect.
作者
李汨
LI Mi(Department of Clinical Laboratory,South District of Xiangtan Central Ho spital,Xiangtan 411101,China)
关键词
鲍曼不动杆菌
院内感染
分布特点
耐药性
抗菌药物
合理用药
Acinetobacter baumannii
Nosocomial infection
Distribution characteristics
Drug resistance
Antibacterial drugs
The rational use of drugs
