A Homology Study Of Multidrug-resistant Acinetobacter Baumannii Infection In The Intensive Care Unit

Objective:Collect specimens from the surrounding environment of the intensive care unit of the hospital,the hands of patients and medical staff,and extract Acinetobacter baumannii(Ab)through bacterial culture,and determine the resistance of this strain to its commonly used antibiotics Multi-drug resistant Ab(MDRAB)strains.Analyze the homology of the clinically extracted Abs in our hospital to understand the infection of multiple Acinetobacter baumannii in the intensive care unit of our hospital,and the surface contamination of the hands of medical staff and the high-frequency exposure of the hands to the environment To find out the links that need to be focused on in medical care,analyze the causes of hospital infections,propose control measures,and provide references for reducing nosocomial infections.Methods:From January 1st,2018 to December 31 st,2018,select 5 new intensive care units in the hospital(ICU,emergency ICU(two wards),respiratory intensive care unit,neurology intensive care unit)Receiving patients,excluding patients who were repeatedly hospitalized in the same patient and transferred to these 5 monitoring units,sputum samples were collected within 24 hours and 72 hours after the patient was admitted to the hospital,and high-frequency exposure environmental samples and key caregiver hand samples were taken.Collected and extracted 45 strains of Bauman Acinetobacter strains from various clinical specimens.The sensitivity of 45 strains of A.baumannii strains to 15 commonly used antibacterial drugs was determined.Among them,24 strains were multi-resistant,and the pulsed-field gel electrophoresis technique was applied to the isolated multi-resistant Acinetobacter baumannii(PFGE)analysis of bacterial homology.Results:Analysis of 45 strains of Acinetobacter baumannii antimicrobial susceptibility test results,there are 24 strains of Acinetobacter baumannii against amoxicillin /clavulanic acid(AMC),amikacin(AMK),cephalosporin(CEP),cephalosporin Thioxime(CTX),ticarcillin(TLC)and gentamicin(GEN)are all resistant to ciprofloxacin(CIP),piperacillin / tazobactam(TZP),ticarcillin / carat Tretinoin(TCC),ceftazidime(CAZ),cefepime(FEP),aztreonam(ATM),imipenem(IMP),melopenem(MEM),compound sinomethamine(SXT)and other clinical The widely used antibacterial drugs are also mostly insensitive or only moderately sensitive,with multiple drug resistance manifestations.Forty-five Abs contain 24 sputum specimens,suspicious environmental factors,and medical staff 's hands,and a total of 24multi-drug resistant Abs.PFGE homology analysis was performed on these multi-drug resistant Abs.Based on the PFGE typing map,A-K was used to represent different types of Abs.MDRAB,among these strains,very few strains correspond to the genotyping part of type A and type J,represented by A,and J,.Type A strains are the main epidemic strains,which are detected in the sputum and environment of patients with ICU,EICU,and NICU,suggesting that there are multiple cross-infections of Acinetobacter baumannii in different departments.The sputum samples 1,2,and 4 in the ICU are the same as the MDRAB detected at the junction of the suction tube 10 and the negative pressure suction,the 12 sputum samples in the EICU are the same as the MDRAB detected in the bed bed 16,and the 20 in the NICU The sputum specimen is the same as the MDRAB detected by the hand of nurse No.21 and the infusion pump of No.22.Analysis conclusionThrough analysis,it can be seen that the surface of contaminated objects,such as infusion pumps,bed rails,and suction suction connected to the suction tube are the key causes of MDRAB nosocomial infection.MDRAB may also be transmitted by the hands of medical staff.Therefore,in the prevention of MDRAB infection,the key to hand hygiene should be highly recognized,and the hand hygiene of medical staff should be strengthened.For patients with MDRAB infection and bacterial colonization,contact isolation measures should be taken to try to isolate infected patients Arranged in a single room,if the conditions do not allow,bedside isolation measures should be taken;MDRAB is very easy to cause infection in the hospital environment,so it is necessary to enhance the hospital environmental sanitation management,comprehensive cleaning and disinfection treatment of the environment,daily wiping,cleaning and disinfection At work,MDRAB-infected patients and colonized patients need to be scientifically and effectively disinfected when they leave the ward.