Analysis Of Resistance And Homology Of Carbapenem-resistant Acinetobacter Baumannii In A County-level Hospital From Western Chongqing

Objective:The resistance rate and homology analysis of carbapenem-resistant Acinetobacter baumannii(CRAB)isolated from a county-level hospital hospital were analyzed,combined with the results of clinical distribution and homology,so as to get the epidemic trend of CRAB,and provide evidence for preventing and controlling the spread of CRAB.Methods:clinical distribution and drug resistance of 166 patients infected with CRAB admitted in a Class?Grade A comprehensive hospital from Western Chongqing between January 1 2015 and December31,2016 were retrospectively analyzed.and selected during a certain period of time of the 62 strains of CRAB by pulsed field gel electrophoresis test(PFGE)and homology analysis.Results:18 strains was isolated from community,and 140 strains was isolated from hosipital,Community and nosocomial infection in patients withgender(adjusted?~2=2.08,P=0.15),smoking(?~2=1.22,P=0.27),drinking(?~2=0.36,P=0.55)had no significant difference;while in the age distribution,the age of the patients was significantly higher than that of community acquired hospital infection patients,the difference was statistically significant(t=4.73,P<0.01);in the original cases,community infection patients and nosocomial infection in patients with chronic lung disease(adjusted?~2=15.27,P<0.01),diabetes(adjusted?~2=5.40,P<0.05)there are obvious differences in distribution,the difference wasstatisticallysignificant.thedrugresistancerateto piperacillin/tazobactam,gentamicin and tobramycin was higher than 80%,to ampicillin/sulbactam,levofloxacin was 64.5%and 48.2%respectively,some strains were susceptible to compound SMZ and amikacin,the drug re sistance rate of which is lower than 25%.The distribution of drug sensitivity results between community-acquired infections and nosocomial infections had no significant difference(P>0.05).Pulsed-field gel electrophoresis(PFGE)experiments were performed on 62 CRAB isolated from various clinical specimens,and and analyzed by homology analysis.Results 14 different PFGE genotypes(A~N)were identified from 62 strains,the 5 genotypes contains only 1 strains,5 strains of bacteria that has a unique PFGE band type,the other 9 types respectively containing 2 to 11strains,including clone F(n=11),K(n=10),G,I(n=9),H(n=6),A(n=5),L(n=3),C,N(n=2).Conclusion:CRAB was mainly nosocomial infection,which was sensitive to Amikacin and compound sulfamethoxazole,and there was no difference in drug resistance between community infection and nosocomial infection.The epidemic of CRAB in the hospital has two forms of external and internal transmission,which should be strengthened to control the infection.