Drug Resistance Of Anaerobic Infections And Analysis Of Risk Factors For Mortality Of Anaerobic Bacteremia

Objective: To analyze the clinical data of patients with anaerobic infection,to study its drug resistance status and drug resistance mechanism,and to analyze the risk factors for mortality of anaerobic bacteremia,so as to provide a basis for clinicians to identify anaerobic infections and use rational drug as early as possible.Methods: The clinical data of patients with anaerobic infection in our hospital from January 2012 to July 2017 were collected,including gender,age,underlying disease,type of infection,and empirical antibiotic treatment.Risk factors for mortality of anaerobic bacteremia were analyzed by Chi-square test and multivariate logistic regression analysis.The minimal inhibitory concentrations(MICs)were determined by agar dilution method.Antibiotic resistance genes(cepA,ermF,cifA,nim)were amplified by PCR.Results: From January 2012 to July 2017,239 patients with anaerobic infection were detected in our hospital,of which 105 were bacteremia and134 were non-bacteremia patients.The sensitive rates to imipenem,piperacillin-tazobactam and metronidazole were more than 90.00%,and cifA gene was detected in 2 strains resistant to imipenem.Among 105 patients with bacteremia,21 died,accounting for 20%.Univariate logistic regression analysis showed that age and Clostridium infection were risk factors for anaerobic bacteremia death.Multivariate logistic regression analysis showed that age(OR=1.080,95%CI=1.033 to 1.129,P=0.001)and hematological malignancy(OR=42.899,95%CI=3.206 to 574.038,P=0.005)were independent risk factors for mortality.Conclusion: Imipenem,piperacillin-tazobactam and metronidazole have good in vitro activity against anaerobes.The mortality of anaerobic infections is high.Age and hematological malignancies suggest poor prognosis.Therefore,Clinicians should identify early and adopt active and effective treatment measures.