痰标本中耐亚胺培南鲍曼不动杆菌检出变化趋势及耐药性
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周秀岚

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R181.3+2

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2013年内蒙古自治区自然基金立项资助项目(2013MS11113)


Change in detection trend and antimicrobial resistance of imipenemresistant Acinetobacter baumannii from sputum specimens
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    摘要:

    目的了解痰中耐亚胺培南鲍曼不动杆菌(IRAB)检出情况、耐药性及病区分布。方法 回顾性分析2009年1月1日—2013年9月30日某院痰标本分离的鲍曼不动杆菌(AB),比较IRAB和非IRAB的病区分布、耐药性,以及IRAB检出率的变化趋势。结果痰中共检出AB 711株,其中IRAB 442株,非IRAB 269株。AB主要分布在重症监护病房(ICU,39.10%)和神经内科(25.18%);ICU检出IRAB 254株(占57.47%),多于非IRAB(24株,占8.92%),差异有统计学意义(χ2=165.50,P<0.05);IRAB的检出率:ICU(91.37%)高于非ICU(43.42%),差异有统计学意义(χ2=257.29,P<0.05)。2009—2013年IRAB的检出率持续升高(分别为25.30%、36.36%、74.68%、65.56%和90.07%)。IRAB对阿米卡星的耐药率较低(27.25%),非IRAB对阿米卡星和哌拉西林/他唑巴坦的耐药率较低(7.31%、8.24%);除复方磺胺甲口恶唑外,IRAB对其他抗菌药物的耐药率均高于非IRAB,差异均有统计学意义(均P<0.05)。结论痰中IRAB检出率和耐药率均较高,临床应做到早培养、早治疗、早隔离,减少医院多重耐药菌的产生。

    Abstract:

    ObjectiveTo  realize detection, antimicrobial resistance, and ward distribution of imipenemresistant Acinetobacter baumannii (IRAB ) from sputum.MethodsAB strains isolated from sputum specimens in a hospital between January 1, 2009 and  September 30, 2013 were analyzed retrospectively.  Ward distribution, antimicrobial resistance, and isolation rates  between  IRAB and nonIRAB strains were compared.Results711 AB strains were isolated from sputum, 442 of which were IRAB, 269 were nonIRAB.AB were mainly distributed in intensive care unit(ICU, 39.10%) and neurology department (25.18%) ; detection rate of IRAB was  significantly higher than nonIRAB in ICU (57.47%[n=254] vs  8.92%[n=24],χ2=165.50,P<0.05), detection rate of IRAB in ICU was significantly higher than nonICU (91.37% vs 43.42%, χ2=257.29,P<0.05). Detection rates of IRAB in 2009-2013 increased continuously (25.30%, 36.36%, 74.68%, 65.56%, and 90.07%, respectively). The resistant rate of IRAB to amikacin was low (27.25%), resistant rates of nonIRAB to amikacin and piperacillin /tazobactam were both low (7.31% and 8.24% respectively);except compound sulfamethoxazole, resistant rates of IRAB to other antimicrobial agents were all significantly higher than nonIRAB strains (all P<0.05).ConclusionThe detection rate and drug resistant rate of IRAB from sputum are both high,  early culture, early treatment,and early isolation should be carried out to reduce the emergence of multidrugresistant organisms.

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周秀岚,赵建平.痰标本中耐亚胺培南鲍曼不动杆菌检出变化趋势及耐药性[J]. 中国感染控制杂志,2015,14(11):740-742. DOI:10.3969/j. issn.1671-9638.2015.11.005.
ZHOU Xiulan, ZHAO Jianping. Change in detection trend and antimicrobial resistance of imipenemresistant Acinetobacter baumannii from sputum specimens[J]. Chin J Infect Control, 2015,14(11):740-742. DOI:10.3969/j. issn.1671-9638.2015.11.005.

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  • 收稿日期:2015-01-20
  • 最后修改日期:2015-04-12
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  • 在线发布日期: 2015-11-30
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