投稿分類 微生物

主委發表種類: 壁報

投稿標題(中): 南部某區域教學醫院Carbapenem-Resistant Acinetobacter baumannii (CRAB)感染者臨床特徵、抗藥性和菌血症相關因素分析研究

投稿標題(英): Clinical Characteristics, Antibiotic Resistance, and Bacteremia Features of Carbapenem-Resistant Acinetobacter baumannii (CRAB) Infections in a Teaching Hospital in Southern Taiwan

投稿摘要: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a commonly encountered pathogen in healthcare-associated infections. Due to limited treatment options, clinical management poses significant challenges. The aim of this study was to investigate the clinical characteristics, antibiotic resistance patterns, and bacteremia features of CRAB-infected patients in a teaching hospital located in the southern region of Taiwan. This retrospective analysis spanned from 2018 to 2021, encompassing a total of 373 strains of A. baumannii isolated from 373 hospitalized patients, with 157 cases classified as CRAB and 216 as Carbapenem-sensitive Acinetobacter baumannii (CSAB) for comparative analysis.The number of CRAB-infected patients and their proportion among A. baumannii infections were as follows: 37 cases (38.1%) in 2018, 42 cases (41.6%) in 2019, 35 cases (48.0%) in 2020, and 43 cases (42.2%) in 2021. There was no significant upward trend in the proportion of CRAB cases over the years (p = 0.614). Chi-square analysis revealed statistically significant differences between CRAB and CSAB-infected patients in terms of age group, specimen type, and drug resistance profiles, including amikacin (AN), ceftazidime (CAZ), cefepime (FEP), gentamicin (GM), levofloxacin (LVX), ampicillin/sulbactam (SAM), trimethoprim-sulfamethoxazole (SXT), tigecycline (TGC), piperacillin-tazobactam (TZP), and cefoperazone/sulbactam (SFP). Subsequent analyses revealed that if A. baumannii exhibited resistance to SAM, the odds ratio for CRAB infection was 24.8 (95% CI = 8.1-75.6, p ＜ 0.001), and if it exhibited resistance to SFP, the odds ratio for CRAB infection was 4.4 (95% CI = 1.1-18.5, p = 0.047). Overall, resistance to SAM and SFP was associated with CRAB infection. Furthermore, a chi-square analysis was performed on the bacteremia cases of CRAB and CSAB, showing statistically significant differences in drug resistance profiles (CAZ, GM, SAM, SXT, IPM, and TZP) between the two groups. Subsequent analysis indicated that in cases of CRAB bacteremia with SAM resistance, the odds ratio for CRAB infection was 19.5 (95% CI = 1.3-292.8, p = 0.032). This study contributes to a better understanding of the characteristics of CRAB-infected patients and provides valuable insights for drug selection.
Key words: CRAB, CSAB, resistance, bacteremia, mortality

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