Study Of The Distribution And Drug Resistance Of Pathogens Isolated From ICU Patients

Objective To research the distribution and drug resistance of pathogens in intensive care unit(ICU),and to provide a reference for empirical antibacterial treatment of severe infection.Methods A retrospective analysis of bacterial and fungal culture positive cases in ICU hospitalized patients from The Affiliated Jiangning Hospital of NJMU from January 2015 to December 2017 was conducted.Vitek2 automatic microbial identification and drug sensitivity analysis system was used to identify and analyze the isolated bacteria.The data were analyzed by WHONET 5.6 software.Results Between 2015 and 2017,1765 non-repetitive isolated pathogens were detected in ICU,including 1334 Gram-negative bacteria(75.6%),200 Gram-positive bacteria(11.3%),and 231 fungi(13.1%).Top 10 ranking isolated pathogens were:Pseudomonas aeruginosa(17.1%),Acinetobacter baumannii(16.0%),Klebsiella pneumonia(14.8%),E.coli(11.3%),Exotic proteus(10.4%),Candida albicans(6.3%),Staphylococcus epidermidis(5.8%),Candida glabrata(3.3%),Staphylococcus aureus(2.8%)and Serratia marcescens(2.3%).The extended-spectrum β-lactamase(ESBL)strains of Klebsiella pneumoniae,E.coli,Proteus mirabilis,and Serratia marcescens accounted for 54.6%,82.0%,5.4% and19.5%,respectively;Carbapenem resistant Enterobacteriaceae(CRE)accounted for17.5%;MDR strains of Acinetobacter baumannii and Pseudomonas aeruginosa accounted for 85.8% and 33.2%,respectively.The detection rates of MRSA and MRCNS were 49.0% and 97.1%,respectively,and no vancomycin-resistant Enterococci strains were found.No voriconazole,amphotericin B or5-fluorocytosine resistant Candida strains were detected.Conclusion The predominant pathogens isolated from ICU patients were gram-negative bacteria,with high detection rates of MDR strains.Comprehensive surveillance programs are needed to track the origins and emergence pathways of resistant pathogens in ICU.