Analysis Of Pathogenic Bacterium Distribution And Drug Resistance In Lower Respiratory Tract Infection In Basic-level Hospital

Objective:To analyze pathogenic bacterium distribution and drug sensitivity and resistance to the inpatients suffered from lower respiratory tract infection, and to observe the effect using empirical antibiotic, and guiding correct empiric antibiotic therapy in patients with lower respiratory tract infection, and reducing the occurrence of drug-resistant bacteria in clinical. According to the results of drug sensitivity of reasonable application of antibiotics,to reduce the occurrence of ICU unit of bacterial resistance.Objects and Methods:Susceptibility of bacteria and drug resistance results were retrospectively analyzed in Xianshuigu hospital (second class A level hospital) from2010March to train in2013March in sputum specimens of1312patients with lower respiratory tract infection, to analyze sputum culture, and record inspection results. To analyze results of sputum culture of patients with community acquired pneumonia, and hospital acquired pneumonia. to analyze bacterial drug sensitivity and resistance in patients, and retrospective analysis of the use of normative empirical antibiotic.Results:Among1312cases with lower respiratory tract infection,1086cases were examined by sputum smear and sputum culture, detection rate is82%.450cases is Gram-positive bacteria in1086patients with sputum smear results, accounting for41.4%; gram negative bacteria in628cases, accounting for57.8%.50cases of fungus (42of them were complicated with other bacterial infection), accounted for4.6%The result of sputum culture, no pathopoiesia grows in500cases, accounting for46.1%; sputum samples of586strains of pathogens were isolated, including12strains of Gram-positive bacteria, accounted for2%, Gram-negative bacteria574strains, accounting for98%,50strains of fungi, accounted for4.6%. Cefazolin, ampicillin, amoxicillin/clavulanic acid have high resistance to Gram-negative bacteria; co-trimoxazole, ampicillin resistant rate was44.1%, cefazolin resistance rate was28.6%, the compound sulfamethoxazole resistant rate was28.4%, the amoxicillin/clavulanic acid resistant rate of20.9%. Mainly Gram-negative bacteria in community acquired pneumonia sputum smear, sputum culture results show some pathopoiesia grows (Laboratory Department of the hospital and sputum culture conditions of instrument and method); sputum smear are Gram-negative bacteria in hospital-acquired pneumonia, sputum culture mainly for Klebsiella pneumoniae, Enterobacter cloacae and Acinetobacter. especially in ICU are Pseudomonas aeruginosa bacteria and full of Bauman Acinetobacter, and to choose the high antibiotic resistance, and showed multiple drug resistance. The fungus Candida albicans was the main species, generally sensitive to antifungal drugs. The use of antibiotics, the common ward empiric therapy mainly use the second generation cephalosporin and penicillin beta-lactamase inhibitor, patients in ICU with mild and general wards antibiotic is basically the same, in patients with severe, mechanical ventilation support respiratory and immune function is low to meropenem, the fungal to voriconazole.Conclusion:The species of pathogenic bacterium were various, and limited conditions in basic-level hospitals, sputum culture significance is poor in the clinical. But showed mainly community acquired pneumonia of gram positive bacteria, hospital acquired pneumonia with gram-negative bacilli infection accounted for the majority, ICU in Pseudomonas aeruginosa and Bauman Acinetobacter, drug resistance rate is higher and with multi-drug resistance. Empiric antibiotic use is reasonable and effective, the hospital ward bacterial drug resistance rate is low, but the ICU of bacterial drug resistance rate...