目的 分析北京市海淀醫(yī)院多重耐藥鮑曼不動(dòng)桿菌（multidrug-resistant Acinetobacter baumannii，MDR-AB）臨床感染的特點(diǎn)及耐藥性，為臨床用藥提供一定的理論依據(jù)。方法 將北京市海淀醫(yī)院2018年10月—2019年10月分離的178株鮑曼不動(dòng)桿菌（Acinetobacter baumannii）作為研究對(duì)象，對(duì)其相關(guān)臨床資料及體外藥物敏感性試驗(yàn)結(jié)果進(jìn)行分析。結(jié)果 鮑曼不動(dòng)桿菌多重耐藥率為46.6%，且97.6% MDR-AB為耐碳青霉烯鮑曼不動(dòng)桿菌（CR-AB）。MDR-AB主要分離自高齡（>60歲）患者（86.7%）和重癥監(jiān)護(hù)室（ICU）患者（65.1%），且86.7% MDR-AB分離自痰液標(biāo)本。MDR-AB對(duì)各種常用抗菌藥物的耐藥率明顯高于普通鮑曼不動(dòng)桿菌，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；MDR-AB中同時(shí)耐碳青霉烯類、氟喹諾酮類、抗銅綠假單胞菌青霉素加酶抑制劑類、廣譜頭孢菌素類、氨基糖苷類、四環(huán)素類等抗菌藥物的菌株的占比最高（39.8%）。結(jié)論 高齡和ICU患者是MDR-AB的主要易感人群，MDR-AB對(duì)各種常用抗菌藥物的耐藥率明顯高于普通鮑曼不動(dòng)桿菌，替加環(huán)素對(duì)MDR-AB的耐藥率相對(duì)低于其他抗菌藥物，臨床應(yīng)合理使用抗菌藥防止MDR-AB的產(chǎn)生和傳播。

Objective To analyze the clinical infection characteristics and drug resistance of of multidrug-resistant Acinetobacter baumannii (MDR-AB), so as to provide evidence for clinical rational drug use. Methods The relative clinical data and in vitro drug sensitivity test results of 178 Acinetobacter baumannii strains isolated from Beijing Haidian Hospital from October 2018 to October 2019 were analyzed. Results The multidrug resistance rate of AB was 46.6% and 97.6% of MDR-AB were carbapenem resistant Acinetobacter baumannii (CR-AB). MDR-AB were mainly isolated from elderly patients (> 60 years old, 86.7%) and the patients in intensive care unit (ICU, 65.1%), and 86.7% of MDR-AB were isolated from sputum samples. The drug resistance rates of MDR-AB to commonly used antibiotics were significantly higher than that of AB (P<0.05). The MDR-AB that were resistant to carbapenems, fluoroquinolones, anti-pseudomonas aeruginosa penicillin-enzyme inhibitors, broad-spectrum cephalosporins, aminoglycosides and tetracyclines together accounted for the highest proportion (39.8%) among all the MDR-AB. Conclusion The elderly and the patients in ICU are the main susceptible population of MDR-AB. The drug resistance rate of MDR-AB to various commonly used antibiotics is significantly higher than that of AB. The drug resistance rate of tegacyclin to MDR-AB is relatively lower than that of other antibiotics. Antibiotics should be used rationally to prevent the emergence and spread of MDR-AB.

R978.1