Study On Bacterial Resistance And Its Syndromes In Hospitalized Patients Of Respiratory Department In Dongzhimen Hospital In Recent 5 Years

PurposeThrow a retrospective analysis of incidence of bacterial resistance in Dongzhimen Hospital Respiratory Department of internal medicine patients from August 2010 to August 2015, to summarize the characteristic of patients with lung infection caused by drug-resistance bacteria in the age of onset, duration of hospitalization, basic disease, TCM syndrome, the use of antibiotics. Try to find out the potential law of pathogenesis in patients with drug-resistant infections, to evaluate the feasibility of traditional Chinese medicine in delaying or reversing drug resistance of bacteria.MethodsTo collect 145 cases of drug resistance patients who Once checked in Beijing university of Chinese medicine dongzhimen hospital respiratory medicine from August 2010 to August 2015. To Analysis patient’s age, sex, duration of hospital days, basic disease, TCM syndrome, the distribution of drug resistant bacteria, the extent of the drug resistance, the using of antibiotic. Adopt SPSS 19.0 statistical data packet count data applications chi-square test, measurement data analysis of variance.The Results1 The study found that the age from Bacteria resistant patients was concentrated in 70-80 phase. On the basis of respiratory disease, chronic obstructive pulmonary disease, chronic pulmonary heart disease, lung cancer take up the top three. Other basic diseases in the Department of internal medicine ward to occupy the top five are hypertension, coronary heart disease, electrolyte disorders, cerebral infarction and hypoproteinemia. The average Duration of hospitalization of bacteria resistant patients was 19±9.8 days. Including 84 cases of patients hospitalized days reached more than three weeks.2 The research shows that resistance is mainly dominated by Gram negative bacteria, a total of 126 cases, the proportion is as high as 87%, Pseudomonas aeruginosa is the most common; there are only 28 cases of gram positive bacteria, Mainly composed of Staphylococcus aureus. The highest resistance rate of antibiotics is beta lactam antibiotic.There are 94 percents of drug-resistant bacteria show drug resistance to it. Quinolones and aminoglycosides were ranked in second and three. In beta lactams, fluoroquinolones and aminoglycosides, the antibiotic with highest rate of drug resistance in their own was ampicillin, levofloxacin and gentamicin respectively. The type of drug resistance:to 1-2 of antibiotic resistance occupy the most, a total of 88 cases? The multi drug resistance and pan drug resistant bacteria were detected in 56 cases, accounting for about 40%. In 145 cases, there are 9 cases of MRS A,4 cases of MRSCON and 1 case of ESBLs producing strains. In addition, there are more than half of patients with pulmonary infection caused by the resistant bacteria accompanied by fungal infection.3 In 145 cases of bacterial resistant patients, lung distension, syndrome characterized by dyspnea and cough occupy the top three; The syndrome distribution is mainly intermingled deficiency and excess, accounted for 57% of all cases; Among the deficiency syndrome, Qi deficiency and Yin deficiency syndrome occupy a large proportion, accounted for 34%,25% respectively. The main parts of the lesion is lung, kidney and spleen. In the symdrom of excess, syndrome of heat-phlegm and syndrome of intermingled phlegm and blood stasis in the proportion of 46and 39 respectively, take up the top two. Phlegm, heat, blood stasis were the main pathogenic factors.Conclusion1 Bacterial resistance in respiratory department of internal medicine occurs in 70-80 years old patients, especially those with chronic obstructive pulmonary disease, chronic pulmonary heart disease and lung cancer. If accompanied by underlying disease, like hypertension, coronary heart disease, electrolyte disorders, cerebral infarction and hypoproteinemia, the resistance rate is rising more obviously, more prone to multiple resistance and pan drug resistant etc. In addition, bacterial resistance may lead to prolonged length of hospital stay.2 Bacterial drug resistance in patients with pulmonary infection in Department of respiration is mainly gram negative bacteria, Pseudomonas aeruginosa, Acinetobacter Bauman and Klebsiella pneumoniae take up the top three, which is basically identical with statistics data from the two major domestic drug resistance monitoring systems. The highest resistance rate of antibiotics is beta Iactam. In addition, there are more than 50 percepts of the lung infection caused by the resistant bacteria, accompanied by fungal infection.3 The syndrome distribution is mainly intermingled deficiency and excess; Among the deficiency syndrome, Qi deficiency and Yin deficiency syndrome occupy a large proportion,. The main parts of the lesion are lung, kidney and spleen. In the syndrome of excess, syndrome of heat-phlegm and syndrome of intermingled phlegm and blood stasis take up the top two. Phlegm, heat, blood stasis were the main pathogenic factors.