Department of Laboratory, Dongying People's Hospital, Dongying, Shandong, China.
Eur Rev Med Pharmacol Sci. 2018 Mar;22(6):1782-1786. doi: 10.26355/eurrev_201803_14597.
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.
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.
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.
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.
研究鲍曼不动杆菌血流感染的临床和细菌学特征及耐药性，为鲍曼不动杆菌血流感染的治疗提供新依据。
对 2016 年 7 月至 2017 年 6 月我院收治的 74 例鲍曼不动杆菌血流感染患者的临床和细菌学特征及药敏进行统计分析。
74 例患者中，约 72.0%入住 ICU 和呼吸科；患者平均年龄 63 岁。74 例患者中，62 例住院时间>2 周（83.8%），35 例>1 个月（47.3%）；72.0%的患者经历有创操作，其中 28.0%的患者死亡。药敏实验显示，替加环素敏感性最高（100%），其次为阿米卡星（>90.0%）及其他抗菌药物（<40.0%）。42 例患者为泛耐药菌，占 56.8%。泛耐药组与非泛耐药组比较，阳性血培养前 2 周内，碳青霉烯类抗菌药物的使用和有创操作有统计学差异（p<0.05）。患者对碳青霉烯类抗菌药物的最低耐药率为 8.16%，而对其他 12 种抗生素的耐药率均>40.00%。多重耐药菌主要来源于 ICU 和烧伤中心。
鲍曼不动杆菌血流感染患者中，泛耐药株占绝大多数，死亡率高。年龄、有创操作、住院时间>2 周是常见的易感因素，而碳青霉烯类抗菌药物的使用和有创操作可能是导致泛耐药株的高危因素。
