2010-2019年上海市某医院多重耐药鲍曼不动杆菌的临床分布及耐药性分析

目的 分析2010-2019年上海市青浦区中医医院多重耐药鲍曼不动杆菌的临床科室分布情况及耐药性。方法 对上海市青浦区中医医院2010-2019年检出的394株鲍曼不动杆菌进行回顾性分析,使用法国生物梅里埃VITEK-2 Compact60全自动细菌鉴定及药敏分析仪,药敏结果根据美国临床和实验室标准协会标准进行判读。结果 2010-2019年10年间鲍曼不动杆菌菌株数呈逐年上升趋势,其中多重耐药菌株63株,占16.0%。分离的鲍曼不动杆菌主要来源于痰液标本,共检出374株,占94.9%。分离的鲍曼不动杆菌及多重耐药菌株均主要分布于住院内科病房,菌株多分离自55岁以上男性人群。药敏试验结果显示,鲍曼不动杆菌对阿米卡星和哌拉西林/舒巴坦非常敏感。结论 临床医生应该严格执行抗菌药物使用原则,重视病原学检查,根据药敏结果合理选择敏感性强的抗菌药物,避免抗菌药物的长期使用,最大限度地减少耐药菌株的产生。

Clinical distribution and drug resistance of multidrug resistant Acinetobacter baumannii in a hospital in Shanghai from 2010 to 2019

Objective To analyze the distribution and drug resistance of multidrug resistant Acinetobacter baumannii in clinical departments of Shanghai Qingpu District Hospital of Traditional Chinese Medicine from 2010 to 2019.Methods A retrospective analysis of 394 strains of Acinetobacter baumannii in Shanghai Qingpu District Hospital of Traditional Chinese Medicine from 2010 to 2019 was conducted,French bioMerieux VITEK-2 Compact60 automatic bacteria identification and drug sensitivity analyzer was used.The drug sensitivity results were judged according to the standards of American Society for Clinical and Laboratory Standards.Results From 2010 to 2019,the number of Acinetobacter baumannii increased year by year,including 63 multidrug resistant strains,accounting for 16.0%.The isolated Acinetobacter baumannii mainly came from sputum samples,and 374 strains were detected,accounting for 94.9%.From the distribution of departments,Acinetobacter baumannii and multidrug resistant strains were mainly distributed in the inpatient department,mostly in men over 55 years old.According to the drug sensitivity,Acinetobacter baumannii was very sensitive to amikacin and piperacillin/sulbactam.Conclusion Clinicians should strictly implement the application principle of antibiotics,pay attention to etiological examination,reasonably select highly sensitive antibiotics according to drug sensitivity results,avoid long-term use of antibiotics,and minimize the generation of drug resistant strains.