Department of Clinical Research Center, Dazhou Central Hospital, Dazhou, Sichuan province, China.
Department of Clinical Pharmacy, Dazhou Central Hospital, Dazhou, Sichuan province, China.
Mol Biol Rep. 2024 Jan 16;51(1):120. doi: 10.1007/s11033-023-09144-3.
The isolation rate and drug resistance rate of Acinetobacter baumannii (A.baumannii) have increased over the years, which has become one of the main causes of infection and death in intensive care unit (ICU) patients. Analysis of the distribution characteristics, drug resistance and influencing factors of A.baumannii in ICU could provide basis and reference for the infection prevention and clinical treatment.
In this study, patients diagnosed with A.baumannii infection in ICU from January 2020 to December 2021 were selected. Samples of patients were collected for bacterial culture, drug sensitivity test analysis and drug resistant gene detection of A.baumannii. A total of 197 strains of A.baumannii were cultured in 2021, which was 18 strains more than in 2020. The specimens were mainly from lower respiratory tract secretions, and the isolated strains were multi-drug resistant. The resistance of isolates to tobramycin, gentamicin, and trimethoprim-sulfamethoxazole in 2021 showed a significant increase compared to 2020, while there were no significant differences observed in other resistance changes. The prevalence of multi-drug resistant A.baumannii in ICU remains high. Among them, all imipenem-resistant A.baumannii strains carried OXA-23 gene.
Clinical treatment should use antibiotics reasonably based on the characteristics of bacterial resistance, and strengthen the prevention and control of hospital infection, pay more attention to the disinfection and isolation to reduce the risk of cross infection.
鲍曼不动杆菌(A.baumannii)的分离率和耐药率逐年上升,已成为重症监护病房(ICU)患者感染和死亡的主要原因之一。分析 ICU 中 A.baumannii 的分布特点、耐药性及其影响因素,可为感染防控和临床治疗提供依据和参考。
本研究选取 2020 年 1 月至 2021 年 12 月 ICU 诊断为鲍曼不动杆菌感染的患者,采集患者标本进行细菌培养、A.baumannii 药敏试验分析及耐药基因检测。2021 年共培养出 197 株 A.baumannii,比 2020 年多 18 株。标本主要来源于下呼吸道分泌物,分离株呈多药耐药。与 2020 年相比,2021 年分离株对妥布霉素、庆大霉素和复方磺胺甲噁唑的耐药性明显增加,而其他耐药性变化无显著差异。ICU 中多药耐药 A.baumannii 的流行率仍然较高。其中,所有耐亚胺培南的 A.baumannii 菌株均携带 OXA-23 基因。
临床治疗应根据细菌耐药特点合理使用抗生素,加强医院感染防控,重视消毒隔离,降低交叉感染风险。