碳青霉烯类耐药鲍曼不动杆菌在ICU与普通病房中的感染及耐药情况比较

Comparison of infection and drug resistance of carbapenem-resistant Acinetobacter baumannii between ICU and general wards

摘要:

目的 比较碳青霉烯类耐药鲍曼不动杆菌（CRAB）在重症监护病房（ICU）与普通病房中感染及耐药情况。方法 选取2020年1月—2025年1月泰州市第二人民医院收治的84例CRAB感染患者，分为ICU组（49例）、普通病房组（35例）。通过菌株分离与鉴定、药物敏感性分析、耐药基因检测，比较两组CRAB感染部位、耐药特征、耐药基因表型。结果 两组感染部位均以呼吸道为主，但ICU组呼吸道感染占比高于普通病房组，尿道和手术部位感染占比均低于普通病房组（P <0.05）。ICU组氨苄西林/舒巴坦、头孢哌酮/舒巴坦、头孢吡肟和阿米卡星耐药占比均高于普通病房组（P <0.05）。ICU组与普通病房组耐药基因比较，差异均无统计学意义（P >0.05）。结论 ICU与普通病房CRAB感染均以呼吸道为主，但ICU的CRAB菌株表现出更广泛的耐药性。

Abstract:

Objective To compare infection sites and antimicrobial resistance patterns of carbapenem-resistant Acinetobacter baumannii (CRAB) in intensive care units (ICUs) and general wards.Methods A total of 84 patients with CRAB infections admitted to Taizhou Second People's Hospital between January 2020 and January 2025 were selected and divided into an ICU group (49 cases) and a general ward group (35 cases). Through bacterial strain isolation and identification, antimicrobial susceptibility testing, and resistance gene detection, the infection sites, resistance characteristics, and resistance gene phenotypes of CRAB were compared between the two groups.Results Respiratory tract infections predominated in both groups; however, the proportion of respiratory tract infections was higher in the ICU group than in the general ward group, whereas the proportions of urinary tract and surgical site infections were both lower in the ICU group (P < 0.05). In the ICU group, the resistance rates to ampicillin/sulbactam, cefoperazone/sulbactam, cefepime and amikacin were higher than in the general ward group (P < 0.05). There was no significant difference in the distribution of resistance genes between the ICU and general ward groups (P > 0.05).Conclusion CRAB infections in both the ICU and general wards were predominantly respiratory in nature, but CRAB strains in the ICU exhibited a broader spectrum of resistance.