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首页> 外文期刊>Proceedings of the Latvian Academy of Sciences, Section B. Natural, exact, and applied sciences, B dala. Dabaszinatnes >Decreasing Prevalence of Multidrug-Resistant Acinetobacter Baumannii in Rīga East University Hospital / Multirezistentās Acinetobacter Baumannii Izplatības Mazinā?anās Rīgas Austrumu Klīniskajā Universitātes Slimnīcā
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Decreasing Prevalence of Multidrug-Resistant Acinetobacter Baumannii in Rīga East University Hospital / Multirezistentās Acinetobacter Baumannii Izplatības Mazinā?anās Rīgas Austrumu Klīniskajā Universitātes Slimnīcā

机译：里加东大学医院的多重耐药鲍曼不动杆菌患病率/里加东临床大学医院的多重耐药鲍曼不动杆菌患病率

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摘要

There has been an increasing tendency of infections caused by multidrug-resistant organisms (MDRO), including multidrug-resistant Acinetobacter baumannii (MDRAB), in the Rīga East University Hospital (REUH) during the last decade. Over the last two years (2014-2015), this tendency has reversed and the prevalence of MDRAB has decreased considerably. In this study we assessed the prevalence of MDRAB in intensive care units (ICUs), internal medicine, surgery units and analysed antibiotic sensitivity profiles. In addition, we determined if current infection control measures are preventing further increase of infections caused by MDRAB in REUH.Retrospective Acinetobacter baumannii prevalence data were collected for the period from 2009 until 2012. For the time period from the beginning of 2013 until 2015, after implementing such infection control measures as control of compliance to hand hygiene guidelines, a review of central venous catheter insertion protocols and regular search for sources of MDRAB in hospital environment, prospective follow-up of new cases was conducted. Antimicrobial sensitivity profiles were assessed for the period from 2013 until 2015. Data were processed with the statistical software WHONET 5.5. Bacteria identification and antibiotic susceptibility testing were performed by VITEK 2 compact, BioMerieux, France. The prevalence of MDRAB in the period 2009 to 2013 increased from 71 to 217 cases per year, but from between 2013 (time of implementing infection control measures) and 2015 it decreased to 113 cases in 2015. In the three year period (2013-2015), the proportion of MDRAB causing bloodstream infections (BSI) and central nervous system infections (CNSI) was 15.85% from all identified MDRAB cases. Of the 113 MDRAB infections diagnosed in 2015, BSI was found in 16.81% cases (n = 19). Antibiotic resistance testing showed that colistin is the most effective drug against MDRAB. The majority of Acinetobacter baumannii isolates were resistant to Ampicillin/Sulbactam, Piperacillin/Tazobactam, Ceftazidime, Cefepime, Imipenem, Meropenem, Amikacin, Gentamicin, Tobramycin, and Ciprofloxacin. Over the last two years (2014-2015), prevalence of MDRAB infections decreased considerably. In the time period from 2013 to 2014, resistance of Acinetobacter baumannii increased to imipenem, ciprofloxacin and colistin, while decreased slightly to amikacin. Rigorous infection control measures, such as identification and elimination of new MDRAB sources in environment, review of the central venous catheter insertion protocol and improvements in hand hygiene, are crucial for decreasing distribution of and invasive infections caused by MDRAB in the hospital environment.
机译：在过去的十年中，里加东大学医院（REUH）出现了由多重耐药生物（MDRO）引起的感染趋势，其中包括多重耐药鲍曼不动杆菌（MDRAB）。在过去的两年中（2014-2015年），这种趋势已经逆转，MDRAB的患病率已大大降低。在这项研究中，我们评估了重症监护病房（ICU），内科，外科病房中MDRAB的患病率，并分析了抗生素敏感性分布。此外，我们确定了当前的感染控制措施是否能阻止REUH中由MDRAB引起的感染的进一步增加。收集了2009年至2012年期间的回顾性鲍曼不动杆菌患病率数据。从2013年初至2015年，实施感染控制措施，例如控制对手部卫生准则的遵守，对中心静脉导管插入协议的审查以及在医院环境中定期寻找MDRAB的来源，并对新病例进行前瞻性随访。对2013年至2015年期间的抗菌敏感性进行了评估。数据使用统计软件WHONET 5.5处理。细菌鉴定和抗生素敏感性测试由法国BioMerieux的VITEK 2 compact进行。 2009年至2013年期间，MDRAB的患病率从每年71例增加到217例，但是从2013年（实施感染控制措施的时间）到2015年之间，2015年减少到113例。在三年期间（2013-2015年） ），在所有确诊的MDRAB病例中，引起血液感染（BSI）和中枢神经系统感染（CNSI）的MDRAB比例为15.85％。在2015年确诊的113种MDRAB感染中，有16.81％的病例发现BSI（n = 19）。抗生素抗药性测试表明，大肠菌素是对抗MDRAB的最有效药物。鲍曼不动杆菌的大多数分离物对氨苄青霉素/舒巴坦，哌拉西林/他唑巴坦，头孢他啶，头孢吡肟，亚胺培南，美罗培南，阿米卡星，庆大霉素，妥布霉素和环丙沙星有抗性。在过去的两年（2014-2015年）中，MDRAB感染的发生率显着下降。在2013年至2014年期间，鲍曼不动杆菌对亚胺培南，环丙沙星和大肠粘菌素的耐药性增加，而对丁胺卡那霉素的耐药性则略有下降。严格的感染控制措施，例如识别和消除环境中新的MDRAB来源，审查中央静脉导管插入协议以及改善手部卫生，对于减少MDRAB在医院环境中的分布和侵入性感染至关重要。

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