我院呼吸科鲍曼不动杆菌耐药及流行病学特征分析

目的 探讨呼吸科鲍曼不动杆菌耐药及流行病学特征.方法 收集2015年1-12月陆军军医大学第一附属医院呼吸科院内感染患者各类临床标本分离的69株鲍曼不动杆菌,通过医院电子病历系统获得患者临床特征,采用琼脂平板倍比稀释法检测细菌最低抑菌浓度,PCR扩增碳青霉烯酶耐药基因,脉冲场凝胶电泳对鲍曼不动杆菌进行基因分型.结果 呼吸机使用、抗菌药物使用及住院时间是患者感染鲍曼不动杆菌的危险因素(P ＜0.001).除米诺环素外,鲍曼不动杆菌对其他抗菌药物均具有较高的耐药性.所有菌株含有OXA-51基因,51株携带OXA-23基因,13株携带VIM基因,2株携带IMP-4基因.69株鲍曼不动杆菌共分为9个型和19个亚型,其中D型和H型最为普遍流行.结论 我院呼吸科鲍曼不动杆菌耐药率较高,具有耐药基因水平传播和小规模暴发流行的特点.

Drug resistance and epidemiological characteristics of Acinetobacter baumannii isolated from respiratory department of our hospital,Chongqing

ObjeCtive To explore the drug resistance and epidemiological characteristics of isolated Acinetobacter baumannii (A.baumannii).Methods A total of 69 stains of A.baumannii were isolated from the different clinical specimens of nosocomial infectious patients hospitalized in the respiratory department of the First Affiliated Hospital of Army Medical University from January 2015 to December 2015.The clinical data of these patients were obtained from the electronic medical record system of the hospital.The antimicrobial susceptibility was evaluated by agar disk dilution.The carbapenemase resistance genes were amplified by PCR,and the gene types were analyzed by the pulsed-field gel electrophoresis (PFGE).Results Mechanical ventilation,prior antibiotics and long hospital stay were the risk factors for A.baumannii infection (P ＜ 0.001).Except for minocycline,our isolated strains showed high drug resistance rates to the other antibiotics.All the isolates carried OXA-51 gene,and 51 isolates had OXA-23 gene.VIM gene presented in 13 isolates,and IMP gene only existed in 2 isolates.The PFGE results showed that the 69 isolates had 9 different genotypes and 19 subtypes,and D and E genotypes were the most popular.Conclusion Our isolated A.baumannii stains have quite higher resistance rate,and are characterized by horizontal spread of resistance genes and small-scale epidemic outbreak.