| [Objective ] To investigate Acinetobacter spp. Nosocomial infection and analyze the antibiotic resistance profiles of Acinetobacter spp.; To determine the risk factors of the infections. To identify a genotyping method for strains isolated from the patients with nosocomoal infection . [Methods] 1 .hiformation about the patients with Acinetobacter nocosomial infection during June 2004 to December 2004 were obtained retrospectively. Distribution and clinical features of Acinetobacter spp. Nosocomial infection(NI) in a teaching hospital were studied. The antibiotic resistance profiles were specifically analyzed. 2. 71 patients with Acinetobacter nosocomial infection were compared with the controls through a 1:1 case control study. The data was analyzed by SAS 6.12 software. The logistic regression model was used to analyze the related risk factors of infection. 3.The strains isolated from the cases with nosocomial infection were typed by genomic DNA by using the enterbacter repetitive intergenic consensus PCR (EWC-PCR) method. [Results] 1. The incidence rate and case-time rate of Acinetobacter nosocomial infection was 3.52‰(71/20193) and 3.71% ‰(75/20193) respectively. The patients' mean age was 51.42 years old. The mean day of in-hospital was 54.35. Most of patients with Acinetobacter NI had severe underlying diseases, such as cardiovascular diseases, tumor, respiratory diseases and burn. 2.Acinetobacter NI occurred mainly in intensive care units (ICU) and burn ward, accounted for 29.58%(21/71) and 11.27%(8/71) respectively. NI located in 10 sites, particulary in low respiratory tract (accounted for 73.33%(55/75)), followed by burn wound and up respiratory tract. Most strains of Acinetobacter were isolated from sputum specimens. 3. 18 patients were in co-infection. Among them, 17 patients were infected by two pathogens and 1 by three pathogens . 17 of 71 NI patients recovered ,35 cases got better, 5 cases had no change and 14 cases died. The fatality rate was 19.72%(14/71). 4.The susceptibility test for 14 antibioticagents showed that majority of isolates of Acinetobacter NI were multiresistant strains(68.00%(51/75)).The resistance rate of bacteria for 14 antibiotics were as following;. Imipenem/cilastatin 1.49(1/66), Meropenem 1.49%(l/66), cefoperazone/sulbactam 40.30%(27/67) ,Amikacin 60.29% (41/68) ,Cefepime 63.64% (42/66) ,Piperacillin/tazobactam 65.11 (28/43) ,Ciprofloxacin 66.18%(45/68 ) JLevofloxacin 66.67% (46/69) ,Gentamicin 67.24% (39/58 ) ,Ceftazidime 68.12% (47/69) ,Sulfamethoxazole/trimethoprim 68.42% (39/57) ,Piperacillin 71.01 % ( 49/69 ), Aztreonam 80.56% ( 58/72 ) ,Tetracycline 0.00% ( 0/2 ) . 5.On the basis of multiple logistic regression, only the day of using antibiotics was the independence risk factor for development of Acinetobacter NI(OR=8.945, 95%CI: 1.288-62.107). 6. 53 strains of Acinetobacter baumannii were divided into 28 genetypes by ERIC-PCR. Type C was the epidemical strain in this hospital and the others were sporadic strains, [ Concolusions ] 1.The fatality rate of Acinetobacter NI was very high in this hospital, particulary in ICU and burn ward; The major sites of infection were respiratory tract and burn wound. Most of cases were elderly patients and had severe underlying diseases. Co-infection was found in this investigation. 2.It was indicated that Acinetobacter spp. was highly resistant to the common antibiotics, but was still sensitive to Imipenem/cilastatin and Meropenem. 3. ERIC PCR is an ideal method for molecular epidemiological survey and bacterial gene typing for Acinetobacter .
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