Analysis on the drug resistance and homology of pandrug-resistant Acinetobacter baumannii

doi:10.3969/j.issn.1673-8640.2013.04.006

Abstract

Abstract: Objective　To investigate the drug resistance and homology of pandrug-resistant Acinetobacter baumannii (PDRAB) and analyze the clinical characteristics and outcome of its infection，so as to provide reference for the clinical reasonable medication and the prevention of the infection. Methods　The drug resistance of Acinetobacter baumannii from inpatients of the hospital was determined by automatic microbial identification system of BioMerieux VITEK-2 Compact and Kirby-Bauer method. Retrospective investigation was performed on the clinical characteristics and therapeutic efficacy turnover of the patients with PDRAB infection. A semiquantitative plate assay was used to test the biofilm-forming ability of PDRAB. The homology of PDRAB was detected by pulsed-field gel electrophoresis. Results　A total of 138 Acinetobacter baumannii were isolated，among which 11 (7.97%) isolates were PDRAB. A total of 10 in patients with PDRAB infection were enrolled in the study. The PDRAB infection occurred most frequently in respiratory intensive care unit，7 (70%) isolates were from respiratory intensive care unit，2 (20%) isolates were from surgical unit，and 1 (10%) isolate was from intensive care unit. The polymyxin sensitivity of all 10 PDRAB was 100%，but they were resistant to all other antibiotics in routine clinical use，and the resistance rate was 100%. There were 7 (5.07%) biofilm-positive isolates among the 138 Acinetobacter baumannii，2 isolates were PDRAB，and 5 isolates were non-PDRAB. All of 10 PDRAB were classified into 7 pulsotypes（A，B，C，D，E，F and G），the homology of 2 isolates of Pulsotype D and Pulsotype E was high，and the others were sporadic isolates. Conclusions　Pandrug-resistance is serious in respiratory intensive care unit of the hospital. Pandrug-resistance is closely related to long-term use of broad-spectrum antibiotics，invasive treatment，and patients with multiple underlying diseases. A variety of antimicrobial agents used in combination use have a certain effect on the control of PDRAB infection. It is necessary to strengthen the monitoring of drug resistant and biofilm-positive isolates，especially in respiratory intensive care unit.

Key words: Acinetobacter baumannii, Pandrug-resistance, Risk factor, Biofilm, Pulsed-field gel electrophoresis, Nosocomial infection

ZHAO Fuju 1，LIU Huayong 2，ZHOU Lifang 1，FANG Yi 1，PANG Lifeng 1，LIU Wenjian 1，ZHAO Hu 1. Analysis on the drug resistance and homology of pandrug-resistant Acinetobacter baumannii[J]. , 2013, 28(3): 194-198.

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