| 2014年～2020年鲍曼不动杆菌的临床分布及耐药性分析 |
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| 作者姓名： | 顾津伊 邓德耀 袁文丽 杨秋萍 宋健梅 沈彦均 郭媛媛 徐红云 |
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| 作者单位： | 云南大学附属医院/云南省第二人民医院医学检验科，云南 昆明 650021 |
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| 基金项目： | 云南省科技厅应用基础研究联合专项基金资助项目（2015FB081）；云南省医学学科后备人才培养基金资助项目（H2019046）；昆明医科大学研究生创新基金资助项目（2021S286） |
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| 摘 要： | 目的 探讨鲍曼不动杆菌的临床分布情况及耐药性变迁，为临床合理使用抗菌药物提供参考。 方法 回顾性分析云南省第二人民医院2014年1月至2020年12月临床分离2 453株鲍曼不动杆菌的患者临床资料和药敏结果。 结果 2 453株鲍曼不动杆菌中重症监护室（35.2%）和外科（22.1%）是分离鲍曼不动杆菌的主要科室；云南省第二人民医院检出鲍曼不动杆菌的患者年龄主要分布在大于60岁的年龄段（59.1%），男性分离出鲍曼不动杆菌的检出率（8.64%）明显多于女性（5.39%），P < 0.01，同时男性分离出多重耐药鲍曼不动杆菌的检出率（7.39%）也显著高于女性（3.58%），P < 0.01；鲍曼不动杆菌对哌拉西林、哌拉西林/他唑巴坦、美罗培南、阿米卡星耐药率逐年上升，对左旋氧氟沙星耐药率逐年下降；多重耐药鲍曼不动杆菌分离率逐年上升；耐亚胺培南的鲍曼不动杆菌对哌拉西林等12种抗菌药物耐药率显著高于亚胺培南敏感株。 结论 检出鲍曼不动杆菌的主要科室是重症监护室和外科；男性患者较女性更易检出鲍曼不动杆菌；鲍曼不动杆菌对大部分抗菌药物的耐药率呈上升趋势，多重耐药鲍曼不动杆菌检出率逐年增多，治疗耐亚胺培南的鲍曼不动杆菌抗菌药物选择压力较大，应加强对鲍曼不动杆菌耐药性的监测并合理使用抗菌药物。
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| 关 键 词： | 鲍曼不动杆菌 耐药 抗菌药物 男性 |
| 收稿时间： | 2022-02-01 |
Clinical Distribution and Drug Resistance Analysis of Acineto Bacterbaumannii from 2014 to 2020 |
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| Affiliation: | Dept. of Medical Laboratory，The Affiliated Hospital of Yunnan University/The 2nd People’s Hospital of Yunnan Province，Kunming Yunnan 650021，China |
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| Abstract: | Objective To observe the clinical distribution and drug-resistance of A.baumannii, so as to provide the reference for the rational use of antibiotics in clinic. Methods Data of 2453 A.baumannii isolated from the clinical samples in a hospital from January 2014 to December 2020 were analyzed retrospectively. Results A total of 2453 strains of A.baumannii were mainly isolated from the patients in the Intensive Care Unit （35.2%） and surgery department （22.1%）. The ages of the patients with A.baumannii detected in the hospital were mainly over 60 years old （59.1%）. The detection rate of A.baumannii isolated from the males （8.64%） was significantly higher than that from the females （5.39%） （P < 0.01）. Meanwhile, the detection rate of multidrug-resistant A.baumannii isolated from the males （7.39%） was significantly higher than that from the females （3.58%） （P < 0.01）. In addition to Levofloxacin, the resistance rates to Piperacillin, Imipenem, Meropenem, Piperacillin/Tazobactam and Tetracycline were increasing year by year. The isolation rate of multidrug resistant A.baumannii was also increased in the observation period. Furthermore, the drug resistance rate of the imipenem-resistant A.baumannii to 12 kinds of antibacterial drugs, such as Piperacillin, was significantly higher than that of the imipenem-sensitive strains. Conclusion A.baumannii isolated are mainly from the intensive care unit and surgery department. The susceptibility of the male patients to A.baumannii is higher than that of the females. The drug resistance rate of A.baumannii and the isolation rate of multidrug resistant A.baumannii are on the rise and the detection rate of multidrug-resistant A.baumannii is increasing year by year. It is necessary to strengthen the monitoring of A.baumannii and use antimicrobial agents rationally. |
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