Romanian Society of Pharmaceutical Sciences

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STUDY ON CLINICAL INFECTION OF ACINETOBACTER BAUMANNII IN INTENSIVE CARE UNIT AND AN ANALYSIS OF Β-LACTAMASE RESISTANT GENE

ZONGMIN LIANG, WENBIN SUN, ZHIYUN ZHU, HUIYU TAI, HAIFENG MEI, LIFANG LI*

Intensive Care Unit, Taizhou people’s Hospital, 210 Yingchun Road, Taizhou City, Jiangsu Province, 225300, China

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Acinetobacter baumannii represents a major constituent of nosocomial flora and frequently affects patients from intensive care units (ICUs) and elders. The aim of this study was to investigate the risk factors for clinical infection of Acinetobacter baumannii in ICU, analyse the correlation between clinical empirical antibiotic use and antibiotic resistance, and to identify the β-lactamase resistance genes and drug resistance mechanisms. From 200 non-zymogenous bacteria infected patients treated in the People’s Hospital of Taizhou City, Jiangsu, China, 90 eligible patients were selected to detect the antibiotic resistance mechanism of β-lactamase. Independent factors were determined using multi-bacterial infection and probability regression method. The condition of drug resistance was investigated using agar dilution method. Genes were analysed using polymerase chain reaction (PCR) gene amplification test. The results showed that, 40% of the 160 bacterial strains isolated from the selected 90 patients were Acinetobacter baumannii and the respiratory system was the major infection site. The average age of the subjects when being infected was 67.15 years old; the ratio of male to female was 1.6:1. Deep vein catheterization was an independent risk factor (p < 0.05). The drug resistance rate of Acinetobacter baumannii ranged from 40% to 90%, and it showed a high resistance to five categories of antibacterial agents including cephalosporin, carbapenems, antimicrobials against β-lactamases, fluoroquinolones and aminoglycosides. In all these cases, β-lactamase resistant genes TEM-1, AmpC and IMP were all positive. IMP-1 and OXA-23 metalloenzymes are implicated in the mechanisms by which Acinetobacter baumannii develops multi-drug resistance to β-lactamase antibacterial agents. This study provides a direction for clinical personalized medication.