Clinical Distribution And Drug Resistance Changes Of Acinetobacter Baumannii In A Top Three Hospital In 2015-2017

Objective:Through the investigation from January 1,2015 to December 31,2017,the distribution of Acinetobacter baumannii in the clinical departments of the Northern War Zone General Hospital and the Peace Branch,and the resistance of the pathogens to various commonly used antibiotics for three consecutive years.The overall change of drug rate provides theoretical evidence for clinicians to select sensitive antibiotics,thus effectively controlling infection and further reducing the occurrence of drug-resistant strains.Methods:The results of the tests were collected from various specimens collected from patients in the Northern Theater General Hospital and the Peace Branch during the hospitalization period from January 1,2015 to December 31,2017(excluding patients in non-hospital departments such as outpatients and emergency departments).The results of Acinetobacter baumannii culture showed positive data,and the patient's general condition,clinical department and specimen type were analyzed in detail according to the test report.The MIC method and/or KB method were used for drug susceptibility test,and the bacteria sensitivity,intermediary or drug resistance was determined according to CLSI standard.Data statistics were performed by SPSS 22.0 software,and the epidemiological status of Acinetobacter baumannii in our hospital was retrospectively described,as well as the trend of resistance to common antibiotics in clinical practice.Results:(1)From January 1,2015 to December 31,2017,a total of 663 Baumann strains were isolated from hospitalized patients in our clinical departments.The main G~-series were detected for three consecutive years.In the fourth place,Escherichia coli remained at the highest level,and the detection rates of Pseudomonas aeruginosa and Klebsiella pneumoniae ranked second and third respectively.(2)From the distribution of population of Bowman infected patients,males are 2.2 times more likely to be females,mainly older than 60 years old,with an average age of 67.75 years.(3)The largest proportion of Bauman strains isolated from clinical departments was 22.17%in the ICU ward,followed by 14.48%in the comprehensive ward and 12.67%in the respiratory department.The main types of specimens were mainly from sputum 69.38%,followed by urine 11.01%,secretion specimen 8.60%,throat swab specimen 7.09%,and blood specimen 1.51%.(4)All drug-resistant strains have not been detected in the 663 Bauman strains detected as of 2017-12-31,and most of the commonly used antibiotics(such as ciprofloxacin,imipenem,ceftazidime,etc.)The drug resistance rate is>45%,and the resistance rate of polymyxin B is the lowest,which is 0.40%in 2015,0.83%in 2016,and1.18%in 2017.Sensitivity to minocycline and cefoperazone/sulbactam.Sex is always at a relatively high level(>80%).Studies have shown that the resistance of imipenem,ampicillin/sulbactam,cefepime(Maspin),cefoperazone/sulbactam in the 15 commonly used antibacterial drugs has increased significantly in the past 3 years.The trend(P<0.05)was not statistically significant(P>0.05).(5)The separation rate of CRAB and MDR-AB increased significantly year by year,and the difference was statistically significant(P<0.05).Conclusion:Acinetobacter baumannii is widely present in various clinical departments of our hospital.The number of isolates and the isolation rate of three consecutive years have shown a downward trend,suggesting that the pathogen has not yet developed an outbreak in this hospital.The results showed that the drug resistance rate of most of the commonly used antibiotics in the clinical hospitalized patients in the General Hospital of the Northern Theater and the Peace Branch remained at a high level,compared with the Chinese CHINET monitoring data,different across the country.There is a difference in the drug resistance of the bacteria in the geographical area and in different hospitals.Therefore,clinicians should take into account the epidemiological characteristics and drug resistance of this area and hospital before selecting antibiotics,and follow the results of in vitro drug susceptibility test.Prompt for reasonable and prudent application.The drug-resistant strains are increasing year by year.Warnings should be actively sought to be a risk factor for increased bacterial resistance,and a comprehensive treatment strategy is adopted to slow the development of drug-resistant strains.