Risk factors for carbapenem-resistant Acinetobacter baumannii infection in ICU patients with ventilator-associated pneumonia and drug resistance genes
OBJECTIVE To explore the risk factors for carbapenem-resistant Acinetobacter baumannii(CRAB)in-fection in intensive care unit(ICU)patients with ventilator-associated pneumonia(VAP)and observe the drug re-sistance genes.METHODS A total of 665 VAP patients with A.baumannii infection who were treated in Jianyang People's Hospital from Nov 2019 to Dec 2022 were enrolled in the study and were divided into the drug resistance group with 265 cases and the non-drug resistance group with 400 cases according to the status of CRAB infection.The drug resistance-related genes in the CRAB strains were detected,and the risk factors for the CRAB infection were analyzed.RESULTS blaOXA-51,bla ADC and blaOXA-23 were the major drug resistance genes that were detected in the 265 strains of CRAB,and the detection rates were 100.00％,95.47％and 79.62％,respectively.The detec-tion rates of active efflux pump genes abeM,adeJ,macB and craA were 100.00％.The result of multivariate a-nalysis showed that the albumin level less than 35 g/L,Glasgow Coma score(GCS)less than 8 points,length of ICU stay more than 7 days,duration of mechanical ventilation more than 7 days,tracheotomy,use of antibiotics for more than 7 days before the CRAB infection and two-drug or above medications before the CRAB infection were the independent risk factors for the CRAB infection in the VAP patients(P＜0.05).CONCLUSION There are a variety of risk factors for the CRAB infection in the VAP patients.The major drug resistance-related genes in the isolated CRAB strains include blaOXA-51,blaADC,blaOXA-23,abeM,adeJ,macB,craA,abeS,emrB,adeB and emrA.
Ventilator-associated pneumoniaIntensive care unitCarbapenem-resistant Acinetobacter baumanniiRisk factorDrug resistance-related gene
NETL
NSTL
万方数据
维普
