Lower respiratory tract AB infection and drug resistancein ICU artificial airway patients

OBJECTIVE To study Acinetobacter baumannii infection and drug resistance in artificial airway patients in ICU lower airways,so as to provide the basis for diagnosis and treatment of ICU patients with artificial airway.METHODS A total of 140 cases of artificial airway patients in ICU of the hospital from Jul.2011 to Jul.2014 were selected as research subjects.The respiratory pathogens were identified,and A.baumannii were given susceptibility test.RESULTS Totally 84 cases of patients occurred A.baumannii infection,with the infection rate of 60.0%.Totally 474 strains of pathogens were isolated in 140 cases of patients with artificial airway,including 34 strains of gram-positive bacteria（7.2%）,377 strains of gram-negative bacteria（79.5%）,and 63 strains of fungi（13.3%）,and the A.baumannii had the highest detection rate of 35.4%.among them were 168 strains of A.baumanniiisolated.The hospitalization day,the cancer history,bronchoscopy suctioning history and mechanical ventilation before artificial airway construction were the influencing factors for A.baumanniiinfection.The isolation time of A.baumannii in patients with tracheotomy was（10.89±6.34）d,which was significantly later than（5.01±2.13）d of those with tracheal intubation（P＜0.05）.A.baumannii was serious resistant to cephalosporins and quinolones,the resistant rate to amikacin was 39.9%,and the resistant rates to polymyxin,tigecycline and minocycline were17.9%,10.7% and 20.8%,respectively.CONCLUSION The lower respiratory tract A.baumannii infection rate of artificial airway patients is relatively high.The influencing factors for A.baumannii infection are history of cancer,bronchoscopy suctioning history,mechanical ventilation,etc.A.baumannii have serious drug resistance to polymyxin,and low to tigecycline and minocycline.