Analysis Of Drug Resistance And Carbapenemase Genotype Of Acinetobacter Baumannii In A Certain Disease Area

Objective:To understand the resistance of Acinetobacter baumannii isolated from clinical samples sent by the respiratory department of a tertiary general hospital in Tianjin to antibiotics commonly used in the clinic and the prevalence of carbapenemase genotype of carbapenem resistant Acinetobacter baumannii,to master and understand the resistance characteristics of Acinetobacter baumannii in the ward,so as to provide reference for clinical rational use of antibiotics and prevention of nosocomial infection.Methods:1.collecting 47 strains of non-repetitive Acinetobacter baumannii and isolated from clinical specimens of respiratory ward from January 2019 to December 2019.2.Bacterial culture and identification were conducted on the collected bacterial strain specimens.3.The antimicrobial susceptibility test was carried out by Kirby Bauer.4.16 strains of Carbapene-resistant Acinetobacter baumannii were screened out,and the carrying status of carbapenase genes such as OXA-23,OXA-24,OXA-51,OXA-58,KPC,IMP,VIM and NDM in the 16 strains was detected by Polymerase Chain Reaction.Results:1.47 strains were cultured and identified as Acinetobacter baumannii,and the isolated samples were all from sputum.2.47 strains of Acinetobacter baumannii were sensitive to tigecycline,and then sensitive to compound sulfamethoxazole and cefoperazone/sulbactam,with sensitivity rates of 82.92% and 78.72% respectively.The highest resistance rate to fosfomycin was 93.61%,and the resistance rates to imipenem and meropenem were similar,30.04% and 31.91%,respectively.They all had different degrees of resistance to other tested antibiotics.3.47 strains of Acinetobacter baumannii had no PDRAB,with MDRAB accounting for 34.04%(16/47)and XDRAB accounting for 12.77%(6/47).4.Among the 47 strains of Acinetobacter baumannii,16 strains were carbapeneme-resistant(imipenem,Meropenem).16 carbapeneme-resistant acinetobacter baumannii are all sensitive to Tigecycline(100%),eight of compound Trimethoprim/ Sulfa sensitive strains(50%),sensitive to Cefoperazone/Sulbactam temple has 6 strains(37.50%).All the strains were resistant to amikacin,ciprofloxacin,imipenem,ceftazidime,tetracycline and gentamicin.There were 15strains(93.75%)resistant to Meropenem,15 strains(93.75%)resistant to fosfomycin and 12 strains(75%)resistant to levofloxacin.5.15 strains were simultaneously resistant to imipenem and Meropenem,and 1 strain was only resistant to imipenem in 16 carbapene-resistant Acinetobacter baumannii.16 strains of OXA-23(100%)and 16 strains of OXA-51(100%)were detected,but no OXA-24,OXA-58,KPC,NDM,VIM or IMP genes were detected.Conclusions:1.The drug resistance rate of acinetobacter baumannii collected in this area is lower than the national average level,but carbapenem resistance of Acinetobacter baumannii is still relatively serious,so it is necessary to continue to expand the sample size of detection and strengthen the monitoring of MDRAB and XDRAB.2.The major carbapenemase genotypes carried by Carbapene-resistant Acinetobacter baumannii in this ward are OXA-23 and OXA-51.3.Attention should be paid to the emergence of drug-resistant acinetobacter baumannii,and antibiotics should be used rationally according to the results of drug sensitivity to reduce the occurrence of drug-resistant strains.