Analysis Of Pathogen Distribution And Drug Resistance In Emergency Intensive Care Unit During2011to2013

Objective:To investigate the pathogen distribution and drug resistance of bacterialduring the period from2011to2013in emergency ICU Hebei MedicalUniversity Second Hospital2011in EICU of，and to provide reference forthe diagnosis of bacterial infection and control of hospital infection.Methods:Aretrospective analysis was made for all the isolate bacteria from705patients in our unit during a period of2011to2013．meanwhile，analysing thecommon bacteria resistant to the commonly used antibiotics. Excell andSPSS13.0software is used for statistical analysis.Results:1.Of them625bacterial strains were isolated，of them which community-acquired439strains and hospital-acquired186strains accounted for70.2%and29.8%，mainly community-acquired infections.2.The main source of pathogens was respiratory specimens (77.1%),followed by blood(10.6) and urine(8.3%),others(4%) include secretion, drawupon, ncurolymph,catheter tip.3.Isolation rate limited top five highto low were Acinetobacter baumannii(27.1％)， Pseudomonas aeruginosa(20.6％)，Klebsiella pneumoniae(13.6％)，Escherichiacoli(7.7％), coagulase negative staphylococcus(6%) in2011;Acinetobacter baumannii(28.6%) was the most frequently isolatedbacteria,followed by Pseudomonas aeruginosa(14.1％)， Klebsiellapneumoniae(13.6％)， Escherichiacoli(7.7%), coagulase negativestaphylococcus and Staphylococcus aureus(3.6%) in2012; The top fivepathogens were Acinetobacter baumannii(25.7%), Klebsiella pneumoniae(15.5%), Pseudomonas aeruginosa(13.6％), Escherichiacoli(7.8%), Staphylococcus aureus(3.9%) in2013.4.Of them625bacterial strains were isolated，including457strains ofgram negative bacteria，95strains of gram positive bacteria，and73strains offungi, accounted for73.1%,15.2%and1.7%. The proportion of Gram negativebacteria declined each year, from75.4%to71.8%; conversely, the proportionof gram positive bacteria increased, from12.6%,both chi square test (P>0.05)showed no significant difference; fungi were relatively stable fluctuating inthe11.4%-12.1%.5.Gram negative bacteria mainly included Acinetobacter baumannii,Pseudomonas aeruginosa, Klebsiella pneumonia and Escherichia coil.Klebsiella pneumonia and Escherichia coil had a rising trend year by year, chisquare test (P>0.05) showed no significant difference. More than50%ofAcinetobacter baumannii strains were resistant to all the antibiotics testedexpect Cefoperazone sulbactam, at the same time，founding out10strains ofPandrug-resistant.Pseudomonas aeruginosa showed relatively lower resistanceto amikacin、cefoperazone sulbactam, ceftazidime and cefepime, less than40%;however,the resistance to imipenem and meropenem antibiotics increasedgradually,close50%.Some of Klebsiella pneumonia and Escherichia coilstrains were resistant to imipenem and meropenem. The prevalence of ESBLswas10.6%in Escherichia coil and4.5%in Klebsiella pneumonia.6. Gram positive bacteria mainly included Coagulase negativeStaphylococcus(CNS),Staphylococcus aureus and Enterococcus. Theprevalence of menthicillin-resistant strains was33.3%in Staphylococcusaureus and55.8%in Coagulase negative Staphylococcus(CNS), noStanphylococcus strain was resistant to linezolid, wancomycin or teicoplanin.More of Enterococcus faecium trains were isolated than Enterococcusfaecalis, and no strain was resistant to linezolid, vancomycin, teicoplanin.7. Candida albicans is the main of the all fungi. No voriconazole-resistant,itraconazole-resistant, fluconazole-resistant,5-fluorine cytosine-resistant,amphotericin B-resistant fungal strains.Conclusion: Gram negative bacteria as the main pathogenic bacteria was highlyresistant to commonly used antimicrobial agents and multiple drug resistance.The proportion of gram-positive bacteria had a rising trend year byyear;Fungal infection should not be ignored.Clinicians should Strengthen thepathogen and drug resistance surveillance, explore strategies to prevent cross-infection and reduce multi-drug resistant strains.effective measures must betake to improve the cure rate, reduce the emergence of multi drug resistantstrains. the development of cerebrovascular events.