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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NICU42例次,早产NICU1例次,足月NICU4例次,儿童外科NICU5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(χ~2=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 features and drug resistance of Acinetobacter baumannii in neonatal intensive care unit (NICU). Methods The clinical isolates and drug resistance of 4 NICU Acinetobacter baumannii isolates from a hospital from October 2012 to October 2014 were analyzed retrospectively. Results A total of 11 640 newborns were admitted to the four NICUs, and 500 (4.3%) nosocomial infections occurred, of which 51 were Acinetobacter baumannii (n = 52) and 52 were hospitalized. Acinetobacter baumannii infection: 42 cases of extremely preterm NICU, 1 case of preterm NICU, full-term NICU 4 cases, 5 cases of pediatric surgical NICU. The incidence of nosocomial infection of Acinetobacter baumannii in four seasons was statistically significant (χ ~ 2 = 16.05, P <0.05), mainly occurring in spring and summer. Acinetobacter baumannii resistant to piperacillin / sulbactam, cefepime, imipenem and other β-lactam antibiotics and gentamicin higher (> 90%), amikacin The lowest rate of resistance, also up 51.9%. Of the 52 strains of Acinetobacter baumannii, 46 were multidrug-resistant and 3 were extensively drug-resistant. Conclusion The most serious hospital infection of NICU Acinetobacter baumannii is very premature NICU, showing high resistance rate to commonly used antibacterial drugs.