Epidemiological Characteristics Of Acinetobacter Baumannii And Risk Factors Of Multidrug Resistant Acinetobacter Baumannii Infection In A Tertiary Hospital

Objective:Acinetobacter isolated from the second people’s Hospital of Hefei in recent three years was studied on the source of samples,patient information,drug resistance,inflammatory indexes changes,to understand the epidemic characteristics,current situation of drug resistance in our hospital,to explore the risk factors of multidrug resistant Acinetobacter baumannii infection and evaluate the value of inflammatory markers in the early diagnosis of multidrug resistant infection.Methods:A total of 145 patients with AB infection were admitted to the second people’s Hospital of Hefei from January 2019 to December 2011.According to the results of drug sensitivity,86 patients with MDRAB infection were selected as multi-drug resistance group,and 59 patients with NMDRAB as control group.The case data of the patientswere collected by retrospective analysis,The possible risk factors of MDRAB infection were analyzed by univariate analysis and multivariate Logistic regression,the changes of Inflammatory marks in the two groups were analyzed and compared.Meanwhile select 90 strains of CRAB to detect their drug resistance genotypes.Results:The results of this study suggest that sputum samples account for the highest proportion of AB samples,and the clinical department with the highest detection rate of drug resistant bacteria is intensive care unit(ICU).Risk factor analysis shows the sequential or combined use of≥antibiotics before infection is an independent risk factor for MDRAB infection.The white blood cell count(WBC),neutrophil percentage(NE%),neutrophil to lymphocyte ratio(NLR)and systemic immune inflammation index(SII)were significantly increased in patients with MDRABinfection.The detection of drug resistance gene showed that blaOXA-51 gene was detected in all 90 strains of CRAB,and blaOXA-23 gene was detected in 83 strains(92.22%).Conclusion:The detection rate of sputum samples was the highest,in all specimens of Acinetobacter baumannii isolated clinically,so should pay more attention to respiratory infection.The situation of drug resistance in AB is severe,especially in ICU.The combined application of antibiotics promoted the production of multi-drug resistant strains.And WBC,NE%,NLR and SII are helpful for the early diagnosis of MDRAB infection.Drug resistance gene blaOXA-23 is the most popular carbapenem gene among CRAB strains in our hospital,and it is also the main genotype of drug resistance transmission.