Analysis And Study Of Department Distribution And Drug Resistance Of Antibacterial Baumannii From 2011 To 2016

ObjectiveTo Inverstigate the clinical distribution characteristics and drug resistance changes of Acinetobacter baumannii isolated from a hospital from January 2011 to December 2016,to provide evidence for rational use of antibacterials in clinical practice.MethodsBetween 2011 January to 2016 December were collected in clinical isolates in our hospital 714 cases of hospitalized patients with clinical data and 714 strains of Bauman Acinetobacter clinical drug sensitivity results.Statistical analysis of the clinical data were analyzed by WHONET 5.6 and SPSS16.0 software,in order to understand the clinical distribution of Acinetobacter Baumannii and in different departments in a variety of clinical antimicrobial susceptibility and resistance change.Result1.714 strains of Acinetobacter baumannii in our hospital caused widespread infection departments,the main distribution in the intensive care unit(ICU)50.84%(363 strains),and other points of more departments such as breathing The proportions of internal medicine,neurosurgery,neurology,burns,emergency department and cardiothoracic surgery were 9.66%(69 strains),6.16%(44 strains),4.9%(35 strains),4.62%(30strains)%,4.06%(29 strains).The number of Acinetobacter baumannii strains was on the rise,rising from 96 strains in 2011 to 154 strains in 2016,among which the proportion in the ICU department is on the rise,from 44% in 2011 to 60% in 2016.2.From 2011 to 2016,there were 558 strains of Acinetobacter baumannii isolated from 714 clinical isolates,accounting for the highest proportion(78.2%);wound secretions(52 strains,7.3%),blood 27(3.8%);catheters 21strains(2.9%),urine 17,(2.4%);chest / ascites 16 strains(2.2%),the composition ratio of specimens with time The trend is not obvious.3.From 2011 to 2016,714 strains of Acinetobacter baumannii isolated in our hospital were tested against ceftriaxone,cefepime,ciprofloxacin,gentamycin,tobramycin The resistance rates of carbapenems such as meropenem and imipenem are on the rise,rising from 63.5% in 2011 and 64.5% in resistance to carbapenem respectively Up to 83.1% and 85.1% respectively in 2016;The drug resistance rate of minocycline and tigecycline <50%;The drug resistance rate of piperacillin-tazobactam is 80%;the trend of change is not obvious.The resistance rate of ampicillin-sulbactam rose from 73.9% in 2011 to 82.5% in 2016;the resistance rate of cefoperazone-sulbactam rose from 37.5% in 2011 to 59.5% in 2014.4.In the Distribution Department,ICU department and non ICU departments to 15 kinds of antimicrobial resistance and sensitivity were different,for 6 consecutive years in ICU from Bauman Acinetobacter to cefepime and ceftriaxone,ciprofloxacin,ampicillin,Shubatan,tobramycin,piperacillin / tazobactam,meropenem and imipenem were higher than 90%,to Amikacin and levofloxacin,sulperazone resistance were 67%,55.1%,61.7%;non ICU departments except tigecycline and minocycline other 13 antibiotics between 50% and 77%,Minocyline and tigecycline resistance were 20.8%,17.7%;the ICU department in all kinds of antimicrobial resistance were significantly higher than that of ICU.5.The isolation rate of Carbapenem-resistant Acinetobacter baumannii in our hospital has been increasing up to 86.2% with an average rate of 78.8% in the past 6 years.In the distribution of departments,between 2011 and 2016,The CABA isolates ranged from 73.8% to 94.6% with an upward trend.The rates of CABA isolated from non-ICU families ranged from 52.7% to 81.1% The isolation rates of CABA in ICU over 6 years were significantly higher than those in non-ICU departments.ConclusionIn recent years,our hospital Acinetobacter baumannii drug resistance at a high level,resistant to carbapenem Acinetobacter baumannii detection rate at a high level,requiring that we in clinical work must strictly abide by the classification of antimicrobial agents reasonable use System to avoid excessive use of broad-spectrum antibiotics to prevent the emergence of drug-resistant bacteria.Intensify the disinfection and isolation of ICU departments,standardize the aseptic operation of medical staff,sterilize the concept and reduce the route of transmission.The hospital need to strengthen drug resistance Acinetobacter baumannii surveillance,timely detection of multi-drug resistance and pan-drug-resistant infections,strengthen prevention and control measures to reduce the outbreak and prevalence.