Etiological characteristics and risk factors for MDRO infection in patients undergoing endoluminal isolation of aortic dissection
OBJECTIVE To investigate the risk factors for multidrug-resistant bacteria(MDRO)infection after en-doluminal isolation of aortic dissection and its preventive strategies.METHODS A total of 220 patients who under-went endoluminal isolation of aortic dissection in Shaoxing People's Hospital from Jan.2018 to Dec.2022 were se-lected as the study subjects,and the patients were divided into the MDRO infection group(n=25 cases)and the non-MDRO infection group(n=195 cases)according to their postoperative MDRO infection.Clinical data of pa-tients undergoing endoluminal isolation of aortic dissection were collected,samples were collected,pathogen de-tection and drug sensitivity tests were performed on patients with MDRO infection,and MDRO infection status and pathogen characteristics were analyzed,and drug resistance of major pathogens of MDRO infection was ana-lyzed.Multivariate logistic regression analysis was used to analyze the risk factors of MDRO infection in patients after endoluminal isolation of aortic dissection.RESULTS Among 220 patients after endoluminal isolation of aortic dissection,25 patients were infected with MDRO,with an infection rate of 11.36％.A total of 26 strains were cul-tured and isolated,of which 20 strains of gram-negative accounted for 76.92％,mainly Klebsiella pneumoniae and Acinetobacter baumannii.5 strains of gram-positive accounted for 19.23％.One strain of fungus accounted for 3.85％.Klebsiella pneumoniae was highly resistant to sulfamethoxazole,trimethoprim and cefazolin,and more sensitive to tigecycline and amikacin.Acinetobacter baumannii was highly resistant to ciprofloxacin,sulfamethox-azole/trimethoprim,and more sensitive to levofloxacin and tigecycline.Age and preoperative New York College of Cardiology(NYHA)grading were the risk factors for MDRO infections after endoluminal isolation of aortic dis-section(P＜0.05).CONCLUSION The infection rate of MDRO patients after endoluminal isolation of aortic dis-section was high,with Klebsiella pneumoniae and Acinetobacter baumannii being predominant.Klebsiella pneu-moniae was highly resistant to sulfamethoxazole/trimethoprim and cefazolin,and sensitive to tigacycline and ami-kacin.Acinetobacter baumannii was highly resistant to ciprofloxacin,sulfamethoxazole/trimethoprim,and more sensitive to levofloxacin and tigecycline.Older age and preoperative NYHA grade were risk factors for MDRO in-fection in patients after endoluminal isolation of aortic dissection.Therefore,targeted treatment and intervention measures could be taken accordingly.
Aortic dissectionEndovascular isolationMultiple drug resistant bacteria infectionPathogenic bacte-riaDrug resistanceRisk factor
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