Clinical characteristics and therapy of pan-drug resistant Acinetobacter baumannii infection

Objectives To analyze clinical characteristics and therapy of pan-resistant Acinetobacter baumannii(PDRAB) infection and explore the methods for effective therapy and prevention of this infection.Methods Nine hospitalized patients with PDRAB infection confirmed by pathogen and susceptibility testing were analyzed for the risk factors and the treatment outcomes were assessed by case analysis.Results PDRAB infections occurred mainly in patients with severe complications,most of whom had complications by diabetes or hypertension or damaged mucosal integrity due to mechanical ventilation,surgery and catheterization.The polymyxin sensitivity were 100% forthese infections,but all the bacteria identified showed a antimicrobial resistance rates of 100%.The majority of the infections were acquired during hospitalization occurring mainly in the lungs;all the patients had prolonged hospitalization and received antibiotic treatments with high proportions of broad-spectrum antimicrobial agents especially third-generation cephalosporins and quinolones.Exclusive orsequential use of carbapenems and sulbactam in combination with quinolone or aminoglycoside produced favorable effects.Conclusions The prevalence of hospital-acquired pan-resistance of PDRAB infections increased significantly in recent years,particularly in patients with high risk factors.The widespread use of broad-spectrum antibiotics may have some relevance to drug resistant occurrence.The application of carbapenems or sulbactam,or their sequential use,in combination with other agents may produce good effects.