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2014 - 2017年中国一家三级综合医院1294株医院获得性鲍曼不动杆菌的耐药趋势

Resistance Trends Among 1,294 Nosocomial Acinetobacter baumannii Strains from a Tertiary General Hospital in China, 2014 - 2017.

作者信息

He Songzhe, Li Zheng, Yang Qiu, Quan Meilian, Zhao Li, Hong Zhu

出版信息

Clin Lab. 2020 Mar 1;66(3). doi: 10.7754/Clin.Lab.2019.190629.

DOI:10.7754/Clin.Lab.2019.190629
PMID:32162874
Abstract

BACKGROUND

To analyze the difference of the antibiotic resistance of Acinetobacter baumannii (A. baumannii) isolated from our hospital between 2014 and 2017.

METHODS

We retrospectively evaluated the patients with a confirmed diagnosis of A. baumannii infection at a tertiary general hospital in Guilin during the period between January 2014 and December 2017. The following clinical and demographic data were collected: age, gender, specimens, microbiology results, and antibiotic resistance patterns of isolates. Bacterial identification and susceptibility testing were performed using MALDI-TOF MS and VITEK 2 COMPACT systems. The results were analyzed according to the Clinical and Laboratory Standards Institute (CLSI) 2018 definitions.

RESULTS

From 2014 to 2017, 1,294 strains of A. baumannii were detected, 41.5% of which came from ICU. The sputum separation rate from ICU was significantly higher than those from non-ICU (p < 0.05). Except for amikacin, levofloxacin, and compound sulfamethoxazole, the resistant rates of the others increased year by year. Meanwhile, the resistance rate of carbapenem-resistant A. baumannii in our hospital showed a significant upward trend and exceeded the average of the national level in 2016 - 2017.

CONCLUSIONS

The drug resistance of A. baumannii has generally increased, and active measures have been taken to develop the combined application of antibiotics. Further studies should focus on the judicious use of available antibiotics and implementation of strict infection control measures to avoid the rapid spread or clonal dissemination of A. baumannii in healthcare facilities.

摘要

背景

分析2014年至2017年我院分离的鲍曼不动杆菌的耐药性差异。

方法

我们回顾性评估了2014年1月至2017年12月期间在桂林一家三级综合医院确诊为鲍曼不动杆菌感染的患者。收集了以下临床和人口统计学数据:年龄、性别、标本、微生物学结果以及分离株的耐药模式。使用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)和VITEK 2 COMPACT系统进行细菌鉴定和药敏试验。结果根据临床和实验室标准协会(CLSI)2018年的定义进行分析。

结果

2014年至2017年,共检测到1294株鲍曼不动杆菌,其中41.5%来自重症监护病房(ICU)。ICU的痰液分离率明显高于非ICU(p<0.05)。除阿米卡星、左氧氟沙星和复方磺胺甲恶唑外,其他药物的耐药率逐年上升。同时,我院耐碳青霉烯类鲍曼不动杆菌的耐药率呈显著上升趋势,并在2016 - 2017年超过全国平均水平。

结论

鲍曼不动杆菌的耐药性普遍增加,已采取积极措施开展抗生素联合应用。进一步的研究应侧重于合理使用现有抗生素以及实施严格的感染控制措施,以避免鲍曼不动杆菌在医疗机构中快速传播或克隆播散。

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