Research and analysis of 74 bloodstream infection cases of Acinetobacter baumannii and drug resistance

摘要

OBJECTIVE: We aimed at investigating the clinical and bacteriological features and drug resistance of bloodstream infection of Acinetobacter baumannii, so as to provide new evidence for treatment of bloodstream infection of Acinetobacter baumannii. PATIENTS AND METHODS: Statistical analysis was carried out for the clinical and bacteriological features and drug sensitivity of 74 bloodstream infection cases of Acinetobacter baumannii who were admitted to this hospital between July 2016 and June 2017. RESULTS: Among 74 patients, about 72.0% of them were admitted to the ICU and Respiratory Department; the average age of these patients was 63 years old. Among 74 patients, 62 patients stayed in the hospital for over 2 weeks (83.8%), and 35 for over 1 month (47.3%); 72.0% of patients experienced intrusive operation, in which 28.0% of patients dead. The experiment of drug sensitivity showed that tigecycline had the highest sensitivity (100%), sequentially followed by amikacin (over 90.0%) and other anti-bacterial drugs (less than 40.0%). Pan-drug resistance was identified in 42 patients, accounting for 56.8%. Comparison between the pan-drug resistant and non-pan-drug resistant patients showed that in the first two weeks before the positive blood culture, there were statistically significant differences in administration of carbapenem antibiotics and intrusive operation (p<0.05). Among the patients, the lowest resistance to carbapenem antibiotics was 8.16%, while the rate of resistance to other 12 antibiotics was more than 40.00%. Multiple-resistant strain mainly originated from the ICU and the burn center. CONCLUSIONS: In patients with bloodstream infection of Acinetobacter baumannii, the pan-drug resistant strains account for a vast majority with a high mortality rate. Age, intrusive operation and length of stay in hospital longer than 2 weeks are the common susceptible factors, while the administration of carbapenem antibiotics and intrusive operations might be the high-risk factors leading to pan-drug resistant cases.