Analysis Of Drug Resistance And Clinical Distribution Of Bacteria And Molecular Epidemiology Of Acinetobacter Baumannii In Burns Department

Objective:To analyze the distribution,resistance to drugand To understand the recent carbapenem resistance genes of Acinetobacter baumannii which isolated from the burn department from 2010 to 2014。 We use them for guiding the clinical practice.Methods: A retrospective analysis of bacteria in Burns Department from 2010 to 2014.50 strains of Acinetobacter baumanniifrom 2014 were randomly selected and 9 common carbapenem genes were detected by PCR.Results:The results showes obviously that the burn factors have significant relationship with the gender(χ2=24.318,P<0.001)and the extent of burn also have relationship with the time of therapy in statistics(χ2=3,P<0.05).In the meantime bacteria source and pathogen strains distribution has great relationship with each other in statistics(χ2=29.632,P<0.005).Wounds and secretions detection rate were the two highest among them where bacteria were detected from.542 strains were isolated from burn patients.Compared with Gram-positive bacteria(16.6%),Gram-negative bactiria(83.39%)were the dominant in the clinical specimens and the detection rate of Gram-positive reduced gradually during the past 5 years.Only the resistant rates of P.aeruginosa to cefoperazone-sulbactam(43.9%)and of Staphylococcus to quinupristin(1.27%),sulfamethoxazole(27.85%)and chloramphenicolwere(27.85%)were sensitive respectively.Meanwhile other drugs resistant rates of them were all higher than 50%.Considering the age group,In the Gram-positive bacteria,the main dominant species was Staphylococcus aureus in the group of infants and young children(13/19,68.42%)and children(4/4,100%).In the Gram-negative bacteria,Pseudomonas aeruginosa was the dominant dominant species in the three groups.The proportion of the children group was significantly larger than that in the infants and adults(17/31,54.84%)group.There was no significant difference between the infants and adults group.Staphylococcus aureus and other Gram-positive bacteria generally got higher rates of resistance,espicially in infants and young children group which is higher than the adult group level.The resistant rate(56.25%)of the child group was significantly lower in the penicillin piperacillin than in the other two groups.The results showed that the highest rate gene detected was bla OXA-51-like gene(68.30%)and the next was bla OXA-23-like gene which its detection rate was 32.79%.Two types of genes in the multi-drug resistant Acinetobacter Baumannii detection rate was twice as the rate of the non-multiple drug-resistant bacteria.One non-multi-resistant bacteria detected bla OXA-58-like gene.Conclusion:When Gram-positive bacteria infection rate decreased,the resistance rates of Pseudomonas aeruginosa and Staphylococcus resistance increased,which mainly ralated to the use of vancomycin,second-line linezolid and the early scabs strategy.The higher rate of Gram-positive bacteriadetected in children group may be associated with children rarely use vancomycin and linezolidamine.It is recommended that rational select antimicrobial drugsbased on the drug susceptibility.Acinetobacter baumannii is mainly transmitted by respiratory tract.Its high resistance rate situation has been very grim.The detection of carbapenem resistance gene was mainly dominated by bla OXA23 and bla OXA51,the prevalence of multiple drug-resistant bacteria is also associated with them.