NICU鲍曼不动杆菌的医院感染与耐药性分析

摘要

目的 了解新生儿重症监护病房(NICU)鲍曼不动杆菌的临床特征及耐药性.方法 对2012年10月-2014年10月某院4个NICU鲍曼不动杆菌医院感染临床分离情况及耐药性进行回顾性分析.结果 4个NICU共收治新生儿11 640例,发生医院感染500例(4.3％),其中鲍曼不动杆菌医院感染51例(10.2％),52例次.鲍曼不动杆菌感染:极早产NICU 42例次,早产NICU 1例次,足月NICU 4例次,儿童外科NICU 5例次.4个季节鲍曼不动杆菌医院感染发病率比较,差异具有统计学意义(x2=16.05,P＜0.05),主要发生在春、夏两季.鲍曼不动杆菌对哌拉西林/舒巴坦、头孢吡肟、亚胺培南等β-内酰胺类抗生素以及庆大霉素耐药率较高(＞90％),对阿米卡星耐药率最低,也高达51.9％.52株鲍曼不动杆菌中,46株为多耐药菌株,3株为广泛耐药菌株.结论 NICU鲍曼不动杆菌医院感染最严重的是极早产NICU,对临床常用抗菌药物均呈现高耐药率.%Objective To investigate the clinical characteristics and antimicrobial resistance of Acinetobacter baumannii(A.baumannii) in neonatal intensive care units (NICUs).Methods The clinical isolation and antimicrobial resistance of A.baumannii causing healthcare-associated infection(HAD in 4 NICUs of a hospital from October 2012 to October 2014 were analyzed statistically.Results A total of 11 640 neonates were admitted in 4 NICUs,500(4.3 ％) developed HAI,51 (10.2 ％) developed 52 cases of A.baumannii infection.Distribution of A.baumannii infection was as follows:NICU of extremely premature infants,premature infants,full-term infants,and surgical NICU were 42,1,4,and 5 cases respectively.Incidences of A.baumannii HAI in 4 seasons were compared,difference was statistically significant(x2 =16.05,P＜0.05),infection mainly occurred in the spring and summer.A.baumannii had high resistance rates to β-1actam antibiotics (such as piperacillin/sulbactam,cefepime,imipenem)and gentamycin(＞90 ％),resistance rate to amikacin was the lowest (51.9 ％).Among 52 strains of A.baumannii,46 were multidrug-resistant strains,and 3 were extensively drug-resistant strains.Conclusion A.baumannii HAI is most serious in NICU of extremely premature infants,resistance rates to commonly used antimicrobial agents are high.