| BackgroundAcinetobacter baumannii is a kind of nonfermentation gram negative bacilli, and has became an important pathogenic bacteria that causing nosocomial infection. Hospital patients, especially who has a damaged immunity, are more likely to be infected with Acinetobacter baumannii. Carbapenems have been widely used to treat with nonfermentation bacteria infection, but with the increasing clinical usage, resistant rate were increasing year by year. Multidrug-resistant and pandrug-resistant Acinetobacter baumannii have draw a great problem in clinical treatment and infection control. Investigating the distribution, the drug sensitivity of Acinetobacter baumannii and analysing the related factors is extremely important.MethodsEXCEL2007, SAS9.2, SPSS18.0are used to analyse our data. Those data can be divided into three parts:the first part is the drug sensitivity of all the clinical isolates of Acinetobacter baumannii between2006and2011(n=2397).The second part is the preventative usage of antibacterial agent in surgical department between2005and2011(16354cases). The third part is investigation of the usage of breathing machine, indwelling catheter, and deep venous catheter in SICU (Surgical Intensive Care Ward) from2005to2009(615cases).ResultsThe sensitivity rate of antibacterial drug declined year by year. The infection rates of Acinetobacter baumannii in summer and autumn are higher than spring and winter. The most common distribution wards is ICU, respiratory medicine ward, department of burn and cardiothoracic surgery ward.The second generation cephalosporin, ampicillin and cefotaxime are low, while that of the third generation cephalosporin, quinolones, aminoglycoside and carbapenems are higher. Isolates from ICU and surgical department are more resistant than that from medical department. Overall, the sensitivity rates of all the antibacterial agents declined, increased then declined. Department for outpatient became more sensitive since2010. The strains in the imipenem-sensitive group are more sensitivity to other drugs than strains from imipenem-resistant group.The matched-pair analysis data show that the changes of drug sensitivity of ICU are biggest than other department. In all the17drugs, the sensitivity of imipenem, meropenem and amikacin are more likely to change.By our intervention, there are many progress in clinical departments. The qualified rates of drug usage have increased quickly from2009to2010.In the ICU of surgical department, the hospital infection rate of the patients who are treated with invasive treatments was32.03%. The infection rate is2.60%when use only one catheter. At the same time, when using two catheter, the hospital infection was12.85%, using three kinds of duct, the rate was56.40%.ConclusionOur study results suggest that there may be outbreak in our hospitical. We need to do some further study about homology analysis to confirm the speculation.There are more Acinetobacter baumannii in the third quarter, and those strains have a higher sensitivity rate to most drugs. So we guess that temperature and humidity may also have effection on the breed and grow of bacteria.The reasonable use of antimicrobial agents and useful intervention is a long-term work. The change of sensitivity rate may be related with the change of antimicrobial agents usage.Patients in ICU generally have a intensive basis disease, living in hospital for a long time, having more invasive treatment, that result in a high rate of infection.The above detection may be affected by the enroll standard, collecting method, and statistical method. The relevance, the risk of risk factors and some other risk factors that have not been refered need more study. |
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