Objective:To investigate the clinical characteristics of carbapenem resistant Acinetobacter baumannii(CRAB)infection in respiratory and critical care medicine and its resistance to commonly used clinical antibiotics.In order to provide theoretical basis for clinical multi-drug resistant bacteria anti-infection treatment.Methods:The medical records of 181 hospitalized patients diagnosed with CRAB infection in the Department of Respiratory and Critical Care Medicine of Beijing Anzhen Hospital from January 2019 to December 2021 were retrospectively collected.The clinical manifestations,comorbidities and clinical prognosis after infection were analyzed and summarized,and the regional drug resistance mode was determined according to the in vitro drug sensitivity results of the CRAB strain isolated from clinical specimens.Results:Among 181 patients with CRAB infection,the total infection rate was 4.1％,and the elderly aged 65 and above accounted for 151 cases(83.4％).96 cases of chronic obstructive pulmonary disease(53.0％),80 cases of bronchial asthma(44.2％),55 cases of bronchiectasis(30.4％)and 52 cases of lung malignancy(28.7％)were the four most common types of underlying lung diseases requiring hospitalization.At the same time,most of the patients had hypertension in 106 cases(58.6％),mellitus diabetes in 88 cases(48.6％)and heart failure in 50 cases(27.6％).There were 48 patients(26.5％)who had undergone cardiac surgery,43 patients(23.8％)with cerebrovascular diseases and 19 patients(10.5％)with tumors of other solid organs or blood system other than lung malignancies.Clinical specimens were most often derived from sputum in 128 cases(70.7％)and blood in 22 cases(12.2％).In vitro drug sensitivity results showed that after CRAB infection,the drug resistance rate to commonly used clinical antibiotics cefepime(88.9％)and ceftazidme(85.1％)was the highest,followed by ciprofloxacin,ceftriaxone,cefzolin and levofloxacin,which were 65.7％,64.1％,62.4％and 56.4％,respectively.The resistance rate to tigecycline and polycolistin remained low,with 6.1％and 4.4％,respectively.During the study period,the all-cause mortality rate of hospitalized patients after CRAB infection was 16.0％,which was statistically significant compared with that of hospitalized patients infected with non-carbapenem resistant Acinetobacter baumannii(4.5％)(P=0.001).Meanwhile,the median hospital stay of patients with CRAB infection was 12 days(7-18 days),which was significantly longer than that of patients with non-CRAB infection(4-9 days),and the difference was statistically significant(P=0.024).Conclusions:CRAB has a high incidence of infection and is highly resistant to commonly used clinical antibiotics,which leads to limited antimicrobial treatment options and high fatality rate during hospitalization.Therefore,early identification of high-risk groups of drug-resistant bacterial infections and strengthening the implementation of nososoial infection prevention and control measures are crucial for reducing the incidence and fatality rate of drug-resistant bacterial infections.
维普
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