Resistance variation trend and clinical character of multi-drug resistant Acinetobacter baumannii
CHEN Haohao1 CAI Xiaorui2 TANG Danling1 CAI De1 WEI Duncan1 LIN Yun3
1.Department of Pharmacy, the First Affiliated Hospital of Shantou University Medical College, Guangdong Province, Shantou 515041, China;
2.Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Guangdong Province, Shantou 515041, China;
3.Department of Pharmacy, Shantou Central Hospital, Guangdong Province, Shantou 515041, China
Abstract：Objective To analyze the resistance trend of multi-drug resistant Acinetobacter baumanii (MDR-AB) of the inpatients in the First Affiliated Hospital of Shantou University Medical College (“our hospital” for short), in order to provide reference for clinical treatment. Methods Retrospective analysis was used for this study. The clinical data of 902 inpatients with MDR-AB infection from 2013 to 2016 in our hospital were collected. The clinical data such as sex, age, department, clinical diagnosis and drug sensitivity test results were collected. Chi-square test and Pearson were used for statistical analysis. Results The proportion of male to female was about 7 to 3. Majority of the cases were middle-aged and aged, of which over 40% were ＞65 years old, and about 50% were 18-65 years old. Sputum specimen was mainly, which accounted for over 80%. About 10% of the total specimen were blood, urine and secretions. The cases mainly distributed in Department of ICU, Neurosurgery and Neurology. The proportion of Department of ICU and Neurosurgery showed a decreasing trend, during the period from 2013 to 2016, whose proportion were reduced from 43.61% and 36.84% to 23.05% and 25.15% respectively. On the contrary, the proportion of Department of Neurology, Respiratory Medicine and Neonates showed increasingly, whose proportion were increased from 6.77%, 4.51% and 0.75% to 10.48%, 7.49% and 5.69% from 2013 to 2016. The average resistance rate of MDR-AB to Tigecycline and Polymyxin B were below 10%, to Levofloxacin and Cefoperazone/Sulbactan were close to 50%, to the other antibacterials which were analyzed in this study were above 50%, more seriously, ten of these drugs whose resistance were over 80%. In addition, the proportion of MDR-AB increased significantly (P < 0.05). The results of Pearson correlation analysis showed that resistance rates of Ceftriaxone, Cefepime, Gentamycin, Tobramycin and Ciprofloxacin were highly positive correlated with the trend of Imipenem resistance (P < 0.05). Conclusion The isolated MDR-AB are mainly located in Department of ICU, Neurosurgery and Neurology. The resistance rate of commonly used antibiotics to MDR-AB are severe. Rational application of antibacterial drugs and strengthening management of multiple-drug resistant bacteria should be implemented.
2018, Vol. 15 
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