The Epidemiological Characteristics And Risk Factors Of Acinetobacter Baumannii Bloodstream Infections

Objective:To investigate the clinical characteristics and popular trends of acinetobacterbaumannii bloodstream infections, and explore the risk factors of acinetobacterbaumannii bloodstream infections.So we can provide the basis for clinical anti-infective treatment and identify the high-risk patients as soon as possible. Then we can offer certain early interventions to reduce bloodstream infection rates and the fatality rates.Methods:We collected clinical cases of110patients with acinetobacterbaumannii bloodstream infections between January2009and December2009at the first affiliated hospital of zhejiang university. And the demographic datas, check-in unit, basic diseases, drug use, invasive operation, bacterial drug resistance and prognosis were retrospectively analyzed.Results:the110patients with acinetobacterbaumannii bloodstream infection, average age70±1.3, average hospitalization days24±1.4days, the most common ward is ICU ward (68cases,61.8%), followed by medical ward (22cases,20%), surgical ward (20cases, 18.2%).The x2test, different ward acinetobacter baumannii bloodstream infection rate was statistically difference (x2=32.692,P<0.01). In the110patients:with basic diseases of79cases (accounting72%),31cases without foundation disease (accounting28%); with a history of hospitalisation within3months of65cases (accounting59%); The average APACHE-Ⅱ scores of patients who are bloodstream infected before and after24hours was19.6±2.6points;27%patients used immunosuppressant in the two months before infection and68%used antimicrobial agents within3month before the infection.About48%patients have a history of surgery within1month before the infection.Of them,88.2%with all kinds of invasive operations, including68%of the patients using noninvasive or invasive mechanical ventilation. The prognosis of patients with single factor analysis results show that with age, to stay in hospital ward, ICU hospitalization days,3month history, pulmonary infection, infection,2months before the use of immunosuppressants,3months before the use of antibacterial drugs, surgical infection history, invasive operation, invasive mechanical ventilation, central venous catheter,, indwelling gastric tube detaining urethral catheter related (P<0.05), but with the gender, hospitalization days, basic diseases, noninvasive ventilation, ability has nothing to do drugs (P>0.05).Multiariable Logistic regression analysis.Two months before, according to the results of lung infection, infection using immunosuppressant, infection3months before the use of antibacterial drugs, invasive mechanical ventilation, and prognosis of acinetobacter baumannii bloodstream infections statistical differences.Conclusions:Acinetobacterbaumannii bloodstream infections always develops in the ICU patients and who are sick. The patients may often have infection in more areas of the body, with high fatality rate. Usage of immunosuppressant, non-standard use of antimicrobial drugs, surgery, invasive operation, invasive mechanical ventilation are risk factors for acinetobacterbaumannii bloodstream infections. Bloodstream infections caused by acinetobacterbaumannii multiple to multiple drug-resistant bacteria genera. In this case, the fatality rate is high, the prognosis is poor.In clinical, we should attach great importance to the prevention and control of hospital infection. So we can identify high-risk patients and as soon as possible to reduce the factors of bloodstream infections. Then we can offer certain early interventions to reduce bloodstream infection rates and the fatality rates.