Changes In Drug Resistance Of Acinetobacter Baumannii And Its Influencing Factors

Objective:To discuss the changes of resistance of Acinetobacter baumannii to common antibiotics in a third class general hospital in Xianning from January 2017 to December 2019,and the concerned factors of infection in hospital of Acinetobacter baumannii resistant to carbapenem,which can provide theoretical basis for reducing the resistance rate of the bacteria and preventing the infection caused by Acinetobacter baumannii.Method:1.Collect the distribution and drug sensitivity detecting results of pathogenic bacteria from all kinds of samples(non duplicate qualified samples)of hospitalized patients from 2017 to 2019,then analyze the clinical distribution characteristics of Acinetobacter baumannii.The data were divided into carbapenem-resistant group(CRAB group)and carbapenem-sensitive group(CSAB group)according to the results of drug sensitivity,for the purpose of analyzing the distribution of the two groups in the source of specimens and departments.2.Collect the drug sensitivity monitoring results of all kinds of samples(non duplicate qualified samples)from all hospitalized patients infected with Acinetobacter baumannii from 2017 to 2019,and discuss the change of drug resistance rate of Acinetobacter baumannii to various commonly used antibiotics.3.The basic information of patients infected with Acinetobacter baumannii from2017 to 2019 was collected by querying his electronic medical record database.The interfering factors of carbapenem resistant Acinetobacter baumannii infection were analyzed by chi-square test,the statistically different variables were bringed into the logistic regression analysis after that.Finally,the independent interfering factors of carbapenem resistant Acinetobacter baumannii infection were ascertained.Result:1.From 2017 to 2019,the isolation rate of Acinetobacter baumannii was the lowest,but the detection rate of CRAB was the highest.The major source of specimen was sputum,and the difference between CRAB group and CSAB group was statistically significant(P < 0.05).It is widely distributed in departments,the number of patients in CRAB group was distinctly more than the other group(P < 0.05).2.From 2017 to 2019,the drug resistance rate of Acinetobacter baumannii to most antibiotics has no obvious change trend,and the drug resistance rate is very high.The resistance rate to cefoperazone / sulbactam and minocycline was less than 30%.3.Univariate analysis of CRAB infection and patient age(?70 years),length of hospitalization(? 14 days),application of carbapenem antibacterial drugs,combination of antibacterial drugs(?3 types),hypoproteinemia,severe trauma,trachea incision/intubation,arteriovenous catheterization,and invasive mechanical ventilation were associated with carbapenem-resistant Acinetobacter baumannii infection(P<0.05).Therefore,the statistically significant variables were further included in the multivariate logistic regression analysis,and the results showed that age,length of hospitalization,use of carbapenem antibiotics,combination of antibacterial drugs,hypoproteinemia,and invasive mechanical ventilation are CRAB infections independent factors(P<0.05 and OR>1).Conclusion:The detection rate of common drug-resistant bacteria has some differences,and CRAB has the highest detection rate.The drug resistance rate of the bacteria to most antibiotics was high.Moreover,the resistance rate of piperacillin,sulfamethoxazole,minocycline and meropenem showed an upward trend.Preventing the drug resistance rate from rising,the clinical need to continue to actively monitor the resistance rate of bacteria,so as to offer data support for rational drug use and policy-making.The results showed that there were many independent influencing factors of CRAB infection,including older age,longer hospital stay,use of carbapenems,more kinds of antibiotics combination,hypoproteinemia and invasive mechanical ventilation.Therefore,it is essential to enhance the supervision of concerned factors of carbapenem resistant Acinetobacter baumannii,and effectively prevent and control unnecessary infection factors.