血流感染鲍曼不动杆菌耐药性及流行病学研究

发布时间：2018-01-26 08:18

本文关键词： 血流感染鲍曼不动杆菌耐药性流行病学　出处：《现代预防医学》2016年05期 　论文类型：期刊论文

【摘要】：目的了解该院鲍曼不动杆菌(Acinetobacter baumannii,Aba)血流感染(Bloodstream infection,BSI)的临床分布特点及对抗菌药物的耐药性变迁,为指导临床合理选用抗菌药物及感染控制提供依据。方法回顾性分析2012年6月-2015年6月沈阳军区总医院各科室送检的血液标本的临床及微生物资料,根据药敏结果将其分为三组:非多重耐药性鲍曼不动杆菌(non-MDR-Aba)、多重耐药性鲍曼不动杆菌(MDR-Aba)、广泛耐药性鲍曼不动杆菌(XDR-Aba),统计病原菌科室分布、耐药性变迁及转归。采用SPSS 19.0进行统计学分析。结果 3年共收集87株Aba-BSI标本,XDR-Aba和MDR-Aba检出率最高的科室均为ICU(各占74.0%,50.0%)。87例Aba-BSI转归结局显示,死亡率为13.8%(12/87)。统计分析结果显示耐药表型与科室分布无统计学意义(=12.133,P=0.145),但与转归结局具有显著性差异(r=0.354,P0.001),有统计学意义。结论 Aba-BSI最常见于ICU,且面临严峻的耐药形势,因此需要及时制定有效的感染控制政策,对鲍曼不动杆菌进行规范的、连续的耐药监测,控制鲍曼不动杆菌耐药的播散与流行。
[Abstract]:Objective to investigate the blood stream infection of Acinetobacter Baumannii Aba in this hospital. The clinical distribution of BSIs and the changes of antimicrobial resistance. To guide the rational selection of antimicrobial agents and infection control methods retrospective analysis of blood samples from June 2012 to June 2015 in various departments of Shenyang military region General Hospital. Material. According to the drug sensitivity results, they were divided into three groups: non-multidrug resistant Acinetobacter baumannii (non-MDR-AbaA) and multidrug resistant Acinetobacter baumannii (MDR-Aba). The widely drug-resistant Acinetobacter baumannii XDR-AbaAN was used to calculate the distribution of pathogenic bacteria. SPSS 19.0 was used for statistical analysis. Results 87 Aba-BSI specimens were collected in 3 years. The highest detectable rate of XDR-Aba and MDR-Aba was ICU (74.0% and 50.0%, respectively). 87 cases of Aba-BSI showed the outcome. The mortality rate was 13.8% and 12.87%. The results of statistical analysis showed that there was no significant difference between the phenotype of drug resistance and the distribution in the department. But there was significant difference between Aba-BSI and the outcome. Conclusion Aba-BSI is the most common in ICU, and it is faced with severe drug resistance situation. [WT5HZ] [WT5BZ] [WT5 "HZ] [WT5" BZ] [WT5 "BZ] [WT5" HZ]. Therefore, it is necessary to formulate effective infection control policies in time, to monitor the drug resistance of Acinetobacter baumannii, and to control the spread and prevalence of the drug resistance of Acinetobacter baumannii.
【作者单位】：辽宁医学院沈阳军区总医院研究生培养基地;南京军区总医院医务部;沈阳军区总医院检验科;沈阳军区总医院感染控制科;
【基金】：辽宁省科技攻关计划(No.2011225021)
【分类号】：R516;R446.5
【正文快照】： 鲍曼不动杆菌(Acinetobacter baumannii,Aba)是常见的引起医院获得性感染(HAIs)的革兰氏阴性非发酵菌[1],可引起血流感染(Bloodstream Infection,BSI),呼吸机相关性肺炎,外科伤口感染,脑膜炎等临床感染[2,3]。流行病学研究表明,ICU鲍曼不动杆菌感染的致死率可以达到10%~43%,而

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