摘要
目的:调查医院鲍曼不动杆菌(AB)临床感染耐药性变化趋势并进行同源性分析,为临床抗感染治疗和院内感染控制提供理论依据.方法:收集了2017~2019年我院临床分离的8863份标本,其中有1773株AB,并分析了AB的耐药性.运用MALDI Biotyper软件,对收集的耐药谱相似的30株耐碳青霉烯类AB(CRAB)进行同源性分析.结果:AB的感染率为20.0%;AB主要来自痰液标本(1430株,80.65%),其次为创面分泌物(76株,4.29%)和支气管灌洗液(43株,2.43%).AB主要分布于ICU(1248株,70.39%)及呼吸内科(41株,2.31%).AB对替加环素100%敏感,米诺环素耐药率小于30.00%、头孢哌酮/舒巴坦和复方新诺明耐药率小于70.00%,阿米卡星耐药率变化不显著;共发现耐碳青霉烯类AB1328株(74.90%).MALDI-TOF-MS是一种快速、准确的微生物鉴定技术,实现了对CRAB的特异性分型.结论:AB感染的分离率和耐药率不断升高,需加强临床抗菌药物的合理使用.MALDI-TOF-MS可根据获得的AB蛋白指纹图谱将CRAB划分为不同类型,可作为一种快速的进行溯源的方法.
Objective:To investigate the trend of drug resistance of Acinetobacter baumannii(AB)in clinical infection and analyze its homology,so as to provide theoretical basis for clinical anti-infection treatment and nosocomial infection control.Methods:From 2017 to 2019,8,863 samples were collected,including 1,773 strains of AB,and the drug resistance of AB strains were analyzed.The homology analysis was performed on 30 strains of carbapenem-resistant AB(CRAB)collected with similar drug resistance profiles by means of the software of MALDI biotype.Results:The infection rate was about 20.0%.The main sources of AB samples were from sputum(1,430 strains,80.65%),followed by wound secretions(76 strains,4.29%)and bronchial lavage fluid(43 strains,2.43%).AB was mainly distributed in ICU(1,248 strains,70.39%)and respiratory department(41 strains,2.31%).The resistance rate of 1,773 AB strains to several antimicrobial agents was:100%for tigecycline,less than 30%for Minocycline,and less than 70%for Cefoperazone/sulbactam and Cotrimoxazole.A total of 1,328(74.90%)CRAB strains were detected.MALDI-TOF-MS is a new fast,accurate and high-throughput microbial identification technique for classifying the specificity of CRAB.Conclusion:The separation rate and the drug resistance rate of AB from nosocomial infection were increasing.So,it is necessary to use antimicrobial agents reasonably and normatively.MALDI-TOF-MS can be used to classify CRAB into different types according to the obtained AB protein fingerprint,which can be used as a fast traceability method.
作者
王燕
WANG Yan(Department of Clinical Laboratory,Zaozhuang Municipal Hospital,Shandong Zaozhuang 277102)
出处
《医学检验与临床》
2020年第6期11-15,共5页
Medical Laboratory Science and Clinics
关键词
鲍曼不动杆菌
多重耐药
同源性分析
Acinetobacter Baumannii
Multiple drug resistance
Homology analysis
