摘要
目的了解河北医科大学第二医院2015—2016年鲍曼不动杆菌分布及对抗菌药物的耐药情况,并对其所致感染进行临床价值评估。方法共收集2 253株非重复的细菌,采用Vitek2-Compact进行细菌鉴定和药物敏感试验,应用SPSS 20.0软件进行数据统计分析。结果 2年全院共检出非重复菌株2 253株,其构成比均为14%。在全院检出率居第3位,痰标本检出率为89.5%和91.6%,血标本检出率为2.1%和2.4%,均出现上升。对血流感染相关感染源数据分析显示,仅发现同时痰标本来源的鲍曼不动杆菌,2年检出率为1%和0.8%,未发现由尿及血培养同时检出鲍曼不动杆菌的病例。2年鲍曼不动杆菌对多黏菌素B、替加环素、头孢哌酮/舒巴坦、米诺环素耐药率均低于30%,对美洛培南耐药率为83.8%和76.8%,对亚胺培南耐药率为67.1%和64.4%,多数抗菌药物出现了耐药率不同程度下降。2年鲍曼不动杆菌除对头孢类抗生素及氨曲南血标本耐药率高于痰标本,其他痰标本耐药率均显著高于血标本;其中对呋喃妥因、美洛培南,亚胺培南、头孢吡肟、妥布霉素、左氧氟沙星耐药率差异有统计学意义。结论鲍曼不动杆菌耐药形式依然严峻,下呼吸道感染是鲍曼不动杆菌血流感染的主要来源,定量痰培养、白细胞计数、降钙素原、C反应蛋白的升高可作为血流感染危险因素评估的主要炎性指标。
Objective To investigate the distribution of Acinetobacter baumannii and its resistance to antimicrobial agents in the second hospital of Hebei Medical University from 2015 to2016,and to evaluate the clinical value of the infection.Methods This surveillance totally collected 2 253 strains of non-repetitive bacteria,had a bacteria identification and drug sensitivity test determination with Vitek2-Compact and had a statistic analysis of data with the software of Whonet 5.6.Results In the two years,2 253 non-repeat strains were detected in the whole hospital,and the composition ratio was 14% and 14% in 2015 and 2016 respectively.The detection rate of Acinetobacter baumannii was the third highest in the whole hospital.The detection rate of sputum specimens was 89.5% and 91.6% respectively.The detection rate of blood samples was 2.1% and 2.4%.The detection rate of the sputum specimens and blood samples were 1%,0.8%,no cases of detection of Acinetobacter baumannii were detected by urine and blood culture.In the two years,Acinetobacter baumannii resistance to polymyxin B,tigecycline,cefoperazone/sulbactam,minocycline were less than 30%,the resistance rate to meraceran was 83.8%,76.8%,the resistance rate to imipenem was 67.1%,64.4%,the majority of antimicrobial agents showed a different degree of decline in drug resistance.From 2015 to2016,Acinetobacter baumannii in addition to cephalosporins antibiotics and aztreonam blood samples were higher than the rate of sputum drug resistance,other sputum specimens were higher than the resistance rate of blood samples.Among them,the resistance rate of nitrofurantoin,meropenem,imipenem,cefepime,tobramycin and levofloxacin were significantly different,which was statistically significant.Conclusion Acinetobacter baumannii infection form is still grim,lower respiratory tract infection also led to the risk of bloodstream infection.Quantitative sputum culture,white blood cell count,procalcitonin,increased C-reactive protein were used as a risk factor for bloodstream infection to assess the main inflammatory index.
出处
《河北医科大学学报》
CAS
2017年第12期1439-1442,1447,共5页
Journal of Hebei Medical University
基金
河北省科技计划项目(152777238)
关键词
鲍氏不动杆菌
下呼吸道感染
血流感染
耐药
Acinetobacter baumannii
lower respiratory tract infection
bloodstream infection
resistance
