Study On The Drug Resistance Of Acinetobacter Baumannii In Hospital In Different Departments And Different Specimens From 2010 To 2014

Objectives To investigate the clinical distribution and drug resistance in different specimens of Acinetobacter baumannii of nosocomial infection from 2010 to 2014 in the 3rd degree and grade-A hospital;to provide the reference for clinical rational selection of antibiotics.Methods A retrospective analysis was conducted.From 2010 to 2014,the clinical datas of 613 patients and the sensitivity of 640 strains Acinetobacter baumannii were collected.The clinical datas including gender,age,admission department,the type of isolated specimens,the length of hospital stay,and whether to stay in ICU and the use of antibiotics and other basic information.The isolated strains were cultured.And the drug sensitivity was analyzed by SPSS17.0 software.The distribution characteristics of Acinetobacter baumannii and the sensitivity and the change of drug resistance to the commonly used antibiotics were studied.Results1.From 2010 to 2014,a total number of 640 strains of Acinetobacter baumannii were isolated in clinical.Among them,the sputum specimens of 519 strains of Acinetobacter baumannii were isolated,accounted for 81.1%;followed by wound secretions(60strains)and urine specimens(21 strains).The specimens of Acinetobacter baumannii isolated from blood culture specimens,ascites / pleural effusions and cerebrospinal fluid specimens were less.2.Among the Acinetobacter baumannii isolated in clinical departments,in the Intensive care unit,the detection rate is the highest,accounted for 47.5%.From 2010 to 2014,in the Intensive care unit,the proportion of Acinetobacter baumannii isolated accounted for 37.4%,41.2%,50%,55.3%,47.5%,respectively.The isolation rate of Acinetobacter baumannii is higher in the Department of respiratory medicine,Department of Neurosurgery,Department of Cardiothoracic surgery,Department of Burn.Among them,the separation rate of sputum specimens in respiratory department and Department of neurosurgery was as high as 90%.In the Department of burn,the rate of wound secretion was the highest,and the separation rate was 62%.3.Among the antibiotics often used in clinicial,the drug resistnce of Acinetobacter baumannii to Cefoperazone / sulbactam,Amikacin,Levofloxacin were lower,the resistance rates were 31.4%,53.3%,and 55.5%,respectively;the drug resistance to Minocycline was lower than 35%;the resistance rate against Cephalosporins was the higher.4.In every year,the drug resistance of Acinetobacter baumannii to Cephalosporins were higher than 70%;the resistance to Carbapenems were also higher than 65%.The resistance to Cefoperazone/sulbactam was less than 40%.5.In different specimens,the drug resistance of Acinetobacter baumannii is different.Acinetobacter baumannii in the sputum specimens to Minocycline and Cefoperazone / sulbactam was the lowest,the resistance rate is less than 32%;other types of specimens in Acinetobacter baumannii to Minocycline and Cefoperazone /sulbactam was lower(<30%);resistance to Ceftriaxone,Cefepime and other cephalosporins was higer than 80%.Of wound secretion and urine specimens,Acinetobacter baumannii to Minocycline and Cefoperazone/sulbactam also maintained a good sensitivity,resistance rate is less than 30%;the drug resistant rate of the urine specimens to Minocycline and Cefoperazone /sulbactam is less than 17%.6.In ICU ward,the sputum specimens of Acinetobacter baumannii to Ceftriaxone,Cefotaxime,Cefepime and Ceftazidime were higher than 90%,resistant rate to Imipenem,Meropenem is still higher than 80%;the sputum specimens of Acinetobacter baumannii to Cefoperazone / sulbactam and Minocycline maintained a good sensitivity,resistance rate is less than 40%.The resistance rate of Acinetobacter baumannii separated from the general wards were significantly lower than those in the ICU;resistance to Cefoperazone / sulbactam,Tigecycline and Minocycline were less than 30%,resistance rate of which Cefoperazone / sulbactam and Tigecycline and Minocycline is less than 30%;the resistance rate to Cephalosporins,in addition to Ceftazidime is too high(66.7%),others are less than 50%.Conclusion In the last few years,especially multidrug-resistant Acinetobacter baumannii(MDRAB)has gradually developed into one of the pathogens of nosocomial infection.Acinetobacter baumannii is a serious drug resistance to antibiotics,especially in the Intensive care unit.And it should be strengthened to monitordrug resistance of Acinetobacter baumannii,which is good for the treatment and prevention the infection of Acinetobacter baumannii.