|本期目录/Table of Contents|

[1]谢晖,马秀芝,江海洋,等.鲍曼不动杆菌感染流行病学分析及耐药性监测[J].医学研究与战创伤救治(原医学研究生学报),2022,24(5):476-479.[doi:10.3969/j.issn.1672-271X.2022.05.006]
 XIE Hui,MA Xiu-zhi,JIANG Hai-yang,et al.Epidemiological analysis and drug resistance monitoring of acinetobacter baumannii[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(5):476-479.[doi:10.3969/j.issn.1672-271X.2022.05.006]
点击复制

鲍曼不动杆菌感染流行病学分析及耐药性监测()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年5期
页码:
476-479
栏目:
临床研究
出版日期:
2022-11-02

文章信息/Info

Title:
Epidemiological analysis and drug resistance monitoring of acinetobacter baumannii
作者:
谢晖马秀芝江海洋胡静涛钱竹青王鹏
作者单位:223001淮安,淮安八十二医院检验科(谢晖、江海洋、胡静涛、钱竹青、王鹏);221400徐州,徐州生物工程职业技术学院微生物教研室(马秀芝)
Author(s):
XIE Hui1 MA Xiu-zhi2JIANG Hai-yang1 HU Jing-tao1 QIAN Zhu-qing1 WANG Peng1
(1.Department of Clinical Laboratory, Huai’an 82nd Hospital, Huai’an 223001,Jiangsu, China;2. Department of Microbiology, Xuzhou Biological Engineering Vocational and Technical College,Xuzhou 221400, Jiangsu, China)
关键词:
鲍曼不动杆菌耐药感染流行病学分析
Keywords:
acinetobacter baumanniidrug resistanceinfectionepidemiological analysis
分类号:
R446.5R516
DOI:
10.3969/j.issn.1672-271X.2022.05.006
文献标志码:
A
摘要:
目的通过流行病学方法对鲍曼不动杆菌的感染趋势及耐药性进行分析,为鲍曼不动杆菌的感染预防和临床合理选用抗菌药物提供参考。方法通过医院LIS系统收集淮安八十二医院(原东部战区总医院淮安医疗区)2016年1月1日-2020年12月31日患者送检的临床标本16 573份,共分离出396株鲍曼不动杆菌,对鲍曼不动杆菌感染的检出率、标本来源、年龄分布、病区分布和药敏结果等进行统计分析。结果5年中396例鲍曼不动杆菌平均检出率为8.95%;从检出标本看,鲍曼不动杆菌主要来源于痰(87.12%),其次是伤口分泌物(7.83%);从年龄分布看,鲍曼不动杆菌主要是50岁以上人群有319 例,占比77.2%,尤其是70~80岁年龄段,占了总数25%;从科室分布看,鲍曼不动杆菌主要病区在ICU,占比达64.65%,最低的是普外科,占比1.52%;鲍曼不动杆菌对14种抗菌药物的耐药率均很高,其中亚胺培南和美罗培南均超过80%,相对最低的米诺环素在37.88%~65.38%,对妥布霉素、氨苄西林/舒巴坦 、哌拉西林/他唑巴坦、左氧氟沙星、头孢吡肟、头孢哌酮/舒巴坦、阿米卡星、环丙沙星的耐药率也都大于50%。结论诊疗过程中,重点监测ICU、创伤显微外科和老年科50岁以上患者,做好医院感染防控尤其是对呼吸道预防措施,以减少鲍曼不动杆菌的院内感染及其耐药菌株的播散,合理选择抗菌药物。
Abstract:
ObjectiveTo analyze the infection trend and drug resistance of Acinetobacter baumannii by epidemiological methods,and to provide reference for the prevention of Acinetobacter baumannii infection and the rational selection of antibiotics in clinical practice.Methods16 573 clinical specimens were harvested from patients in Huai’an Hospital from January 1, 2016 to December 31, 2020 by LIS system. A total of 396 strains of Acinetobacter baumannii were isolated. The detection rate of Acinetobacter baumannii infection,specimen source,age distribution,disease area distribution and drug resistance results were statistically analyzed.ResultsThe average detection rate of Acinetobacter baumannii in 396 cases was 8.95%.Acinetobacter baumannii was mainly derived from sputum (87.12%),followed by wound secretion (7.83%).In terms of age distribution,Acinetobacter baumannii was mainly found in people over 50 years old,accounting for 77.2%,especially those aged 70 to 80 years old,accounting for 25% of the total.From the perspective of department distribution,the main area of Acinetobacter baumannii was in ICU,accounting for 64.65%,and the lowest was in the general surgery department,accounting for 1.52%.The rates of drug resistance of Acinetobacter baumannii to 14 kinds of antibiotics were very high.Among them the rates of drug resistance to the meropenem and imipenem are more than 80%,while the lowest relative to minocycline was between 37.88% - 65.38%.The rates of drug resistance to tobramycin and ampicillin/sulbactam,and piperacillin/tazobactam,levofloxacin,cefepime,cefoperazone/sulbactam amikacin,ciprofloxacin were more than 50%.ConclusionIn the process of diagnosis and treatment,we should focus on monitoring the patients over 50 years old in ICU,trauma microsurgery and geriatrics department,and take preventive measures for nosocomial infection prevention and control,especially for respiratory tract,so as to reduce nosocomial infection of Acinetobacter baumannii and the spread of drug-resistant strains,and select antibiotics reasonably.

参考文献/References:

[1]庄璐,章晟,宋婕,等.NICU鲍曼不动杆菌的医院感染与耐药性分析[J]. 中国感染控制杂志,2017,16(11): 1016-1020.
[2]廖一群,江丽霞,凌宝殿,等. 2015-2017年非发酵菌临床分布特点和耐药性变迁[J]. 中国老年学杂志,2019,39(5): 2410-2412.
[3]王黎一,曹旭华,李红,等 . 鲍曼不动杆菌院内下呼吸道感染患者发生多重耐药的危险因素分析 [J]. 河北医药,2020,42(19):3007-3010.
[4]尚红,王毓三,申子瑜. 全国临床检验操作规程[M].4版.北京:人民卫生出版社,2015:1-10.
[5]袁忠林,王鸿. 136株鲍曼不动杆菌耐药性及分布分析[J]. 医学检验与临床,2020,31(1):69-71.
[6]傅美芹,饶东平,余德基. 鲍曼不动杆菌及其耐药性的流行病学分析[J]. 新疆医学,2020,50(10):1059-1062.
[7]彭丹,陈安林,陈泽慧,等. 2014-2016年鲍氏不动杆菌临床分布特征及耐药性变迁[J].中华医院感染学杂志,2017,27(9):1936-193.
[8]刘红梅,韩崇旭,朱小平,等.耐碳青霉烯类鲍曼不动杆菌目标性监测[J].中国感染控制杂志,2017,16(7):593-595.
[9]周华,周建英,俞云松. 中国鲍曼不动杆菌感染诊治与防控专家共识解读[J]. 中国循证医学杂志,2016,16(1) : 26-29.
[10]董宏亮,马岩敏,申遇春,等. 我院抗菌药物使用与鲍曼不动杆菌耐药的相关性分析[J]. 西北药学杂志,2018,33(2):263-266.
[11]黄勋,邓子德,倪语星,等.多重耐药菌医院感染预防与控制中国专家共识[J].中国感染控制杂志,2015,14(1):1-9.
[12]世界卫生组织.世卫组织发布迫切需要新型抗生素的细菌清单[EB/OL].http://www.who.int/mediacentre/news/releases/2017-09-27/bacteria-antibiotics-needed/zh/.
[13]Munoz·Price LS,Weinstein RA.Acinetobacter infection[J].N Engl J Med 2008,358(12):1271-1281.
[14]刘佳蕊. 鲍曼不动杆菌的研究进展[J]. 转化医学杂志,2018,7(6):3.
[15]程建军,Kumar KDINESH,阴晴,等. 鲍曼不动杆菌分子特征及其在替加环素压力下外排泵表达的变化[J]. 医学研究生学报,2020,33(1):18-24.
[16]全国细菌耐药监测网.全国细菌耐药监测网2014-2019细菌耐药性监测报告[J].中国感染控制杂志,2021,20(1):15-31.
[17]刘桂治,李明友,林茂锐,等. 762株鲍曼不动杆菌感染及耐药性分析[J]. 黑龙江医学,2020,433(11):76-78.
[18]王芳,孙奇玫,刘欣,等. 碳青霉烯类耐药与敏感鲍曼不动杆菌医院感染经济损失的差异[J].中国感染控制杂志,2019,18(9):842-847.

相似文献/References:

[1]黄学忠,金彬彬,林佩佩,等.细菌耐药监测预警系统的设计与应用[J].医学研究与战创伤救治(原医学研究生学报),2012,14(04):301.
 HUANG Xue-zhong,JIN Bin-bin,LIN Pei-pei,et al.Design and application of monitoring and warning system of bacterial resistance[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2012,14(5):301.
[2]黄迎娣,崔 蕾,黄利鸣综述,等.上皮间质转化与肿瘤耐药[J].医学研究与战创伤救治(原医学研究生学报),2014,16(06):624.[doi:10.3969/j.issn.1672-271X.2014.06.020]
[3]陈芳芳 综述,李晓军 审校.细胞凋亡在介导非小细胞肺癌耐药调节中的作用[J].医学研究与战创伤救治(原医学研究生学报),2015,17(03):286.[doi:10.3969/j.issn.1672-271X.2015.03.020]
[4]杨 婧,赵 斌,李晓红,等.术后颅内感染菌种分布、危险因素与结局分析[J].医学研究与战创伤救治(原医学研究生学报),2016,18(03):233.[doi:10.3969/j.issn.1672-271X.2016.03.003]
 YANG Jing,ZHAO Bin,LI Xiao-hong,et al.A study of typing ST11 of klebsiella pneumoniae producing carbapenemases by matrix-assisted laser desorption ionization-time of flight mass spectrometry[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(5):233.[doi:10.3969/j.issn.1672-271X.2016.03.003]
[5]徐瑞彤,孙康俊,戴冠群,等.抗雌激素治疗对耐酪氨酸激酶抑制剂非小细胞肺癌细胞株抗增殖作用的机制探讨[J].医学研究与战创伤救治(原医学研究生学报),2017,19(06):581.[doi:10.3969/j.issn.1672-271X.2017.06.006]
 XU Rui-tong,SUN Kang-jun,DAI Guan-qun,et al.The antitumor effect of anti-estrogen therapy on non-small cell lung cancer cell lines with acquired resistance to EGFR-TKI[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(5):581.[doi:10.3969/j.issn.1672-271X.2017.06.006]
[6]王楠,宋小骏,蒋凤,等.维拉帕米及艾灸对长春新碱耐药胃癌细胞株SGC7901逆转增效作用[J].医学研究与战创伤救治(原医学研究生学报),2017,19(06):587.[doi:10.3969/j.issn.1672-271X.2017.06.007]
 WANG Nan,SONG Xiao-jun,JIANG Feng,et al.Reversaland synergisticeffect of verapamil and moxibustion on vincristine resistance in mice with SGC7901 gastric cancer[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(5):587.[doi:10.3969/j.issn.1672-271X.2017.06.007]

备注/Memo

备注/Memo:
基金项目:淮安市自然科学研究计划(HABZ202103)
更新日期/Last Update: 2022-11-16