非鲍曼不动杆菌的临床分布及感染特点分析-现代医学

非鲍曼不动杆菌的临床分布及感染特点分析

单位：苏州大学附属第四医院临床检测中心, 江苏苏州 215123

分类号：R446.5

出版年·卷·期（页码）：2024·52·第八期（1266-1272）

摘要：

目的: 分析临床分离的非鲍曼不动杆菌的临床分布及感染特征。方法: 收集苏州大学附属第四医院2021年1月至2023年6月分离的非鲍曼不动杆菌菌株197株，根据医院不动杆菌、皮特/赛氏不动杆菌及非醋酸钙-鲍曼不动杆菌(ACB)复合群进行分类，并比较其临床分布差异和感染特征。结果: 非鲍曼不动杆菌的分离率逐年增加，不同的非鲍曼不动杆菌对15种药物的耐药率差异无统计学意义。非ACB复合群感染者平均年龄最高(69.68±14.65)岁，医院不动杆菌感染者平均住院时间最长(30.81±18.54) d、ICU入住率(31.25%)和恶化结局(9.38%)比例均最高，3类不动杆菌感染者平均住院时间、ICU入住率比较，差异有统计学意义(P<0.05)。非鲍曼不动杆菌多为医院获得性感染，与其他细菌混合检出多见。与单菌检出患者相比，混合检出患者男性比例、住院时间≥28 d比例、有创操作比例、有ICU入住史比例、白细胞计数、中性粒细胞比例和降钙素原水平均升高，且差异具有统计学意义(P<0.05)。结论: 非鲍曼不动杆菌检出逐年增多，不同的非鲍曼不动杆菌其临床分布和感染特点不同，应加强院内对非鲍曼不动杆菌感染的关注和监测。

Objective: To analyze the clinical distribution and infection characteristics of clinical isolates of non-Acinetobacter baumannii(non-A. baumannii). Methods: A total of 197 non-A. baumannii strains isolated from January 2021 to June 2023 at the Fourth Affiliated Hospital of Soochow University were collected. The strains were classified into A. nosocomialis, A. pittii/seifertii, and non-A. calcoaceticus-baumannii (ACB) complex, and their clinical distributions and infection characteristics were compared. Results: The isolation rate of non-A. baumannii had been increasing annually. There was no statistically significant difference in the drug resistance rates of the different non-A. baumannii strains to 15 types of drugs. The mean age of patients infected with non-ACB complex was the highest[(69.68±14.65) years]. For A. nosocomialis infections, the average hospital stay was the longest [(30.81±18.54) d], the ICU admission rate(31.25%) and the proportion of adverse outcomes(9.38%) were all the highest among the three groups of non-A. baumannii infections. The differences in average hospital stay and ICU admission rates among the three types of non-A. baumannii infections were statistically significant(P<0.05). Non-A. baumannii infections were mostly hospital-acquired, and co-detection with other bacteria was common. Compared with patients with single bacterial detection, those with mixed bacterial detection had a higher proportion of male patients, a higher proportion of long hospital stays(≥28 d), a higher rate of invasive procedures, a higher rate of ICU stay history, increased white blood cell count, increased neutrophil ratio, and higher procalcitonin levels, with all differences being statistically significant(P<0.05). Conclusion: The detection of non-A. baumanni has been increasing yearly, and different non-A. baumannii strains exhibit different clinical distributions and infection characteristics. Therefore, increased attention and monitoring of non-A. baumannii infections in the hospital setting are warranted.

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