| Objective:The study aims to explore the clinical characteristics,drug resistance condition and independent risk factors of hospital infection by multiple drug resistant acinetobacter baumannii nosocomial,to provide scientific basis for the prevention and treatment of multiple drug resistant acinetobacter baumannii nosocomial infection.Methods:117 strains of acinetobacter baumannii were separated and collected from body fluid of hospital patients(excluding neonatal patients and hemodialysis patients)between August 2016 to August 2017 in different departments.According to the eighth edition of the infectious disease hospital infection diagnostic criteria published by people's medical publishing house,specimens were divided into multi-resistant group and non multi-drug resistant group and contaminated and the pathogenic strains were excluded.Moreover,the corresponding clinical data of patients were collected and chi-square test and the multi-factor Logistic regression analysis method were applied to explore the clinical characteristics,drug resistance condition and independent risk factors of hospital infection by multiple drug resistant acinetobacter baumannii nosocomial.Results:1.There were 83 resistant strains and 34 non-resistant strains among the 117 AB strain.The separation rate of the bacteria in the intensive care unit(ICU)is the highest,up to 79.6%(39/49),the respiratory department,neurosurgery,orthopaedics also have high separation rates(76.9%(10/13),60.0%(9/15),61.5%(8/13),respectively).2.Among all kinds of samples,sputum was the most common sample for separation of AB,as high as 73.3%(63/86),and the detection rate in blood,wound secretion and urine were 71.4%(5/7),64.3%(9/14)and 50.0%(2/4)respectively.The infection site of MDRAB in hospital was most common in the lung,followed by bacteremia,wound infection,urinary tract infection and other infection.3.Results of drug susceptibility of 117 AB strains in our hospital showed that the minocycline is most sensitive to AB,the resistant rate is only 12%(10/83),followed by the imine south,cefoperazone/shu ba(62.7%(52/83),73.5%(61/83)).4.The risk factors for hospital infection of AB include age(>60 years old,P = 0.024)hypoalbuminemia(P = 0.049),cardiac insufficiency(P = 0.033),use of urine tube(P = 0.003),use of stomach tube(P = 0.047),dynamic venipuncture(P = 0.000),use of antibiotics for more than 3 days(P = 0.000)and use of immunosuppressant(P = 0.000).Among these risk factors,independent risk factors include use of urine tube(OR=5.322,95%CI :1.023-27.702,P=0.047),stomach tube(OR = 6.199,95% CI: 1.351 28.439,P = 0.019),dynamic venipuncture(OR = 11.568,95% CI: 2.167 61.739,P = 0.004),use of antibiotics for more than 3 days(OR = 10.747,95% CI: 1.556 74.211,P = 0.016)and use of immune inhibitor(OR = 7.992,95% CI: 2.030 31.472,P = 0.003).Conclusion: 1.ICU is the most serious department for MDRAB infection in our hospital.2.The respiratory system is most infected by MDRAB in our hospital.Others include,blood system,wound and urinary system.3.Patients with MDRAB infection in our hospital generally have one or more risk factors.4.The MDRAB strain of our hospital has the weakest resistance to minocycline,and drug resistance to imipenem and cefoperazone/sulbactam is still at a low level.5.MDRAB's hospital infection can be reduced to some extent through some prevention and control measures. |
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