Influencing factors of multi-drug resistantAcinetobacter baumannii infection in patients after liver transplantation
10.3877/cma.j.issn.2095-3232.2016.03.008
- VernacularTitle:肝移植患者术后多重耐药鲍曼不动杆菌感染影响因素
- Author:
Yanping PU
1
;
Yan GU
;
Fu YANG
;
Chunguang WANG
;
Wen PENG
;
Fang FANG
;
Lin ZHONG
Author Information
1. 200080上海交通大学附属第一人民医院肝移植中心
- Keywords:
Liver transplantation;
Multidrug resistance-associated proteins;
Acinetobacter baumannii;
Infection
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2016;5(3):158-162
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the multi-drug resistance condition and independent risk factors ofAcinetobacter baumannii infection in patients after liver transplantation.MethodsClinical data of 257 patients who underwent liver transplantation in Shanghai General Hospital between January 2010 and June 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Twenty-ifve patients were infected with multi-drug resistantAcinetobacter baumannii. Among the patients, 17 were males and 8 were females, 10 were younger than 50 years old and 15 were older or equal to 50 years old. Drug sensitive test was detected using concentration gradient method, metallo-beta-lactamase was detected using composite paper, and bacterial genotype was detected using repetitive sequence polymerase chain reaction (PCR) and gel electrophoresis. Drug resistance, drug-resistant spectrum, genotype distribution, infection time and inlfuence factors of infection for multi-drug resistantAcinetobacter baumannii were observed and analyzed. Single-factor analysis of multi-drug resistantAcinetobacter baumannii was conducted using Chi-squaretest and multiple-factor analysis was conducted using logistic regression analysis.ResultsThe incidence of multi-drug resistantAcinetobacter baumannii infection was 9.7%(25/257).Acinetobacter baumannii strains were highly resistant to aminoglycosides, quinolones, penicillins, cephalosporins and carbapenems, with the drug resistance of 100%. In addition, 96%(24/25) of the strains were metallo-beta-lactamase positive. Three genotypes were observed in the 25 strains ofAcinetobacter baumannii: type B (n=18), type A (n=5) and type C (n=2). Positive postoperative fungal culture (OR=5.470, 95%CI: 1.402-21.333,P<0.05) and re-intubation (OR=11.538, 95%CI: 2.228-59.742,P<0.05) were the independent risk factors for multi-drug resistantAcinetobacter baumannii infection.ConclusionsThe incidence of multidrug-resistant Acinetobacter baumannii infection in patients after liver transplantation is high. Multidrug-resistant Acinetobacter baumannii is highly resistant to multiple antibiotics, and type B is the main genetype. Positive postoperative fungal culture and re-intubation are the independent risk factors for multi-drug resistantAcinetobacter baumannii infection.
