Clinical Distribution And Analysis Of Drug Resistance Of Acinetobacter Baumannii

Objective:To understand clinical distribution and the transition of drugresistance to the common antibiotics of Acinetobacter baumannii isolatedfrom clinic in the China-Japan Unition Hospital of Jilin University from2011to2013. In recent years, with the large number of applications ofbroad-spectrum antibiotics and immunosuppressants and widely carriedout invasive medical procedures, etc. The rate of clinical isolates ofAcinetobacter baumannii is increasing, and the drug resistance is gettingserious,multi-drug resistant Acinetobacter baumannii and evenPan-resistant Acinetobacter baumannii have been found around theworld,it brings serious difficulties for clinical anti-infective therapy. Withthe increase of clinical isolate rate of Acinetobacter baumannii and itsincreasing drug resistance, timely and accurate diagnosis, prevention, andpositive and effective anti-infection treatment is particularly important, todetect the Resistance Monitoring of Acinetobacter baumannii and tounderstand its clinical distribution characteristics is important foreffective treatment of infections caused by Acinetobacter baumannii andthe prevention of spreading in hospitals.Due to the differences among theclimate,equipment condition and treatment measures in different regions and hospitals,the infection and drug resistance and other characteristics ofAcinetobacter baumannii are different.For this purpose,this paperanalyzes the statistical analysis of the source of specimens samplesisolated Acinetobacter baumannii,clinical characteristics and resistancechanges of the patients in our hospital from2011to2013. It also providesan important basis for a reasonable choice of using antibiotics for clinicaland provides assistance for the effective prevention and reduction ofnosocomial infections caused by Acinetobacter baumannii and spreadepidemic.Methods:To collect various types of specimens of inpatients with clinicalinspection from Microbial room of clinical laboratory in China-JapanUnition Hospital of Jilin University during2011-2013.In strictaccordance with the requirements of National Guide To ClinicalLaboratory Procedures to culture isolated strains,all isolated strains areidentified to species applying the MicroScan WalkAway96automatedmicrobial identification system,processing the drug susceptibility testingat the same time.According to the performance standards of antimicrobialsusceptibility testing issued by Clinical and Laboratory StandardsInstitute2013.Using WHONET5.6software for statistical analysis.Results:1.The proportion of Acinetobacter baumannii accounted for clinical isolates Gram-negative bacteriaThe total number of isolated Gram-negative bacteria of our hospitalin2011is2035,including291strains of Acinetobacter baumannii,accounted for14.3%; the total number of isolated Gram-negative bacteriaof our hospital in2012is3103,including424strains of Acinetobacterbaumannii,accounted for13.7%;the total number of isolatedGram-negative bacteria of our hospital in2013is2995,including301strains of Acinetobacter baumannii, accounted for10.1%.2.The specimens constitute of Acinetobacter baumannii.The total number of Acinetobacter baumannii by clincal isolates in2011-2013is1016, Among them,the sputum specimens of734strains ofthe bacteria was isolated, accounted for72.2%;pus discharge of190strains of the bacteria was isolated, accounted for18.7%;urine specimensof21strains of the bacteria was isolated,accounted for2.1%;bloodculture specimens of25strains of the bacteria was isolated,accounted for2.5%;other specimens of46strains of the bacteria was isolated,accounted for4.5%.The main type of isolated specimens of Acinetobacterbaumannii is sputum,accounted for more than50%,followed by pusdischarge.3.The clinical distribution of Acinetobacter baumanniiNeurosurgery have the highest rate of Acinetobacter baumanniiisolated in our hospital clinical departments.Acinetobacter baumannii isolated by Neurosurgery accounted for45.0%,32.3%and32.9%of totalclinical separation rate,respectively, from2011to2013;Neurosurgeryseparation of Acinetobacter baumannii mainly from sputum,theproportion was close to90%for three years,and the results of the analysisshow the drug resistance of neurosurgery isolated Acinetobacterbaumannii is even more serious.Orthopedics, Respiratory Medicine,Thoracic Surgery, ICU, Cardiology, Neurology, Oncology andHematology,Hepatobiliary and Pancreatic Surgery and other departmentsalso have the higher rate of Acinetobacter baumannii isolated.4.The resistant transition of Acinetobacter baumannii to commonly usedantibioticsAccording to the results of our cllinical drug resistance ofAcinetobacter baumannii analysis about2011to2013, cefoperazone/sulbactam was the lowest rate of bacteria resistant to antibiotics, thecomparison of data in2013with2012data shows the resistant rates ofAcinetobacter baumannii to cefoperazone/sulbactam showed anincreasing trend; the resistant rates to carbapenems imipenem was44.4%,48.9%,48.5%, respectively,from2011to2013,more than40percent forthree years; the resistant rates to tetracyclines in2012was16.7%, in2013was51%,data shows resistant rates to tetracyclines showed an increasingtrend; the resistant rates to aminoglycoside drugs amikacin were61.2%,38.2%,35.7%, respectively, from2011to2013,data shows the resistant rates to amikacin showed a downward trend;the resistant rates toquinolone ciprofloxacin star was relatively high,more than50%for threeyears;the resistant rates to levofloxacin for2011and2012was at around50%,declined to35.4%in2013;the drug resistance to cephalosporinantimicrobial was serious, more than50%for three years, includingcefotaxime resistance phenomenon is most serious, more than90%forthree years.5.The differences among samples of different types of resistance inAcinetobacter baumanniiThe lowest resistant rates of antibiotics were cefotaxime of sputum,followed by levofloxacin, imipenem. The resistant rates to cefoperazone/sulbactam are also lowest in other types of specimens, and lower than insputum,followed imipenem,and significantly lower than in sputum.Thedrug resistant rates to amikacin was higher than in sputum.Conclusion:1.Acinetobacter baumannii accounted for a high proportion ofGram-negative bacteria isolated from clinic.2.The main type of isolated specimens of Acinetobacter baumannii issputum.Tip Acinetobacter baumannii major cause respiratory infections.3.Neurosurgery have the highest rate of Acinetobacter baumanniiisolated in our hospital clinical departments.Neurosurgery separation ofAcinetobacter baumannii mainly from sputum,and the drug resistance of Neurosurgery isolated Acinetobacter baumannii is even moreserious.Orthopedics, Respiratory Medicine, Thoracic Surgery, ICU,Cardiology,Neurology,Oncology and Hematology,Hepatobiliary andPancreatic Surgery and other departments also have the higher rate ofAcinetobacter baumannii isolated.4.Three years of data shows that the rate of drug-resistantAcinetobacter baumannii was not change significantly.In the current,cefoperazone/sulbactam and imipenem are still more effective drugs totreat infections caused by Acinetobacter baumannii.5.The lowest resistant rates of antibiotics was cefotaxime of fourcommon types of specimens.The resistant rates to cefotaxime in sputumwas higher than in other types of specimens.The resistant rates toimipenem in sputum was apparently higher than in other types ofspecimens.