长期住院老年患者感染的鲍曼不动杆菌耐药性分析

赵付菊1,方毅1,刘华勇2,周丽芳1,庞立峰1,刘文健1,赵虎1

微生物与感染 ›› 2014, Vol. 9 ›› Issue (3) : 167-173.

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微生物与感染 ›› 2014, Vol. 9 ›› Issue (3) : 167-173.
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长期住院老年患者感染的鲍曼不动杆菌耐药性分析

  • 赵付菊1,方毅1,刘华勇2,周丽芳1,庞立峰1,刘文健1,赵虎1
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Drug resistance of Acinetobacter baumannii isolated from long-term hospitalized elderly patients

  • ZHAO Fu-Ju1, FANG Yi1, LIU Hua-Yong2, Zhou Li-Fang1, PANG Li-Feng1, Liu Wen-Jian1, ZHAO Hu1
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摘要

为了解本院长期住院老年患者感染的鲍曼不动杆菌耐药性特征,本研究收集了2011年9月~2012年8月临床分离自医院老年病区长期住院患者的52株鲍曼不动杆菌,分析菌株的耐药性、产酶类型、生物膜形成能力及耐药基因的携带情况。结果显示,菌株主要分布在呼吸重症监护室,分离的标本以痰液为主,占86.54%。52株鲍曼不动杆菌中,多重耐药菌株最高,占76.92%。对头孢哌酮/舒巴坦耐药率最低,为30.77%,对其余抗菌药物耐药率均在50%以上。产酶阳性率为82.69%,其中产其他水解酶的菌株最多,为63.46%。生物膜的形成能力检出率为5.77%。6株广泛耐药菌株共检出9种耐药基因。结果提示,从老年病区长期住院患者分离的鲍曼不动杆菌耐药现状严重。因此,医院感染控制应以呼吸重症监护室为重点,同时加强对生物膜阳性菌株所分布病区的耐药性监测和消毒隔离,以预防和控制耐药菌的产生和传播。

Abstract

To investigate the drug resistance of Acinetobacter baumannii (A. baumannii) isolated from long-term hospitalized elderly patients in our hospital. A total of 52 isolates of A. baumannii were isolated from September, 2011 to August 2012 from elderly nosocomial patients in our hospital. The types of enzyme production, biofilm-forming ability, drug resistance and carrying resistance genes were tested. The infection of A. baumannii most frequently occurred in respiratory intensive care unit. The main separation sampling was sputum specimens (86.54%).The multi-drug resistant A. baumannii strains were identified mostly (76.92%). A. baumannii isolates showed the lowest resistant rate to cefoperazone-sulbactam, which was 30.77%. The resistant rates to other antimicrobial agents were over 50%. The positive rate of enzyme production was 82.69%, and the most common production was other hydrolytic enzymes (63.46%). The biofilm-forming strains accounted for 5.77% of the isolates. 9 kinds of resistance genes were found in these 6 extensively drug-resistant strains. The study indicates that the grim situation of drug resistance of A. baumannii isolated from long-term hospitalized elderly patients. It is necessary to strengthen the monitoring of drug resistance, especially in respiratory intensive care unit. Meanwhile, drug resistance surveillance and disinfection and isolation should be strengthened in the endemic areas from where the biofilm-positive strains were isolated, so as to prevent and control the production and spread of multi-drug resistant and extensively drug resistant bacteria.

关键词

鲍曼不动杆菌 / 耐药性 / 生物膜 / 医院感染 / 老年患者

Key words

Acinetobacter baumannii / Drug resistance / Biofilm / Hospital infection / Elderly patient

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赵付菊1,方毅1,刘华勇2,周丽芳1,庞立峰1,刘文健1,赵虎1. 长期住院老年患者感染的鲍曼不动杆菌耐药性分析[J]. 微生物与感染. 2014, 9(3): 167-173
ZHAO Fu-Ju1, FANG Yi1, LIU Hua-Yong2, Zhou Li-Fang1, PANG Li-Feng1, Liu Wen-Jian1, ZHAO Hu1.. Drug resistance of Acinetobacter baumannii isolated from long-term hospitalized elderly patients[J]. Journal of Microbes and Infections. 2014, 9(3): 167-173

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