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目的掌握2011-2014年全院多药耐药鲍曼不动杆菌临床分布特征及感染/定植状况,以减少多药耐药现象的发生。方法收集2011-2014年住院患儿标本,医院感染管理科专职人员,每日通过LIS系统,登记MDROs,汇总后分析鲍曼不动杆菌的标本来源、科室分布及感染特点。结果 2011-2014年共分离出多药耐药鲍曼不动杆菌373株,2011-2013年分离率大于70%,两两比较差异无统计学意义(P>0.05)。2014年分离率为36.02%,明显下降(P<0.05)。鲍曼不动杆菌主要分布在有ICU的科室,以重症科、心外科、普外科和新生儿科为主。占91.7%~98.6%以上。鲍曼不动杆菌的标本来源,主要是痰标本,占85.5%~91.9%。其他标本少见。鲍曼不动杆菌的感染部位构成比,下呼吸道感染占首位,构成比为83.6%,其次是呼吸机相关肺炎占6.4%。鲍曼不动杆菌感染主要来自于社区感染占67.0%,院内感染占26.0%,定植菌占7.0%。结论掌握多药耐药鲍曼不动杆菌临床分布规律,应加强耐药性监测,控制ICU等重点病房鲍曼不动杆菌的传播,有利于降低耐药菌检出率。
Objective To investigate the clinical distribution and infection / colonization of multidrug-resistant Acinetobacter baumannii from 2011 to 2014 in order to reduce the occurrence of multidrug resistance. Methods The children hospitalized in 2011-2014 were recruited. The hospital infection management department staffs were recruited daily. The LIS system was used to register the MDROs daily. The specimens were collected and analyzed for the distribution of Acinetobacter baumannii and the distribution characteristics of the departments. Results A total of 373 multidrug-resistant Acinetobacter baumannii strains were isolated from 2011 to 2014, with a separation rate of more than 70% in 2011-2013. There was no significant difference between the two groups (P> 0.05). In 2014, the separation rate was 36.02%, significantly decreased (P <0.05). Acinetobacter baumannii mainly distributed in the department with ICU, mainly in critical, cardiac surgery, general surgery and neonatal. Accounting for 91.7% ~ 98.6%. Acinetobacter baumannii specimen source, mainly sputum specimens, accounting for 85.5% to 91.9%. Other rare specimens. Acinetobacter baumannii infection site composition, lower respiratory tract infection in the first place, the composition ratio was 83.6%, followed by ventilator-associated pneumonia accounted for 6.4%. Acinetobacter baumannii infection mainly comes from community infection accounted for 67.0%, nosocomial infection accounted for 26.0%, colonization accounted for 7.0%. Conclusion To master the clinical distribution of multidrug-resistant Acinetobacter baumannii, drug resistance monitoring should be strengthened to control the transmission of Acinetobacter baumannii in key wards such as ICU, which will help to reduce the detection rate of drug-resistant bacteria.