Analysis Of The Distribution Of Major Pathogens And Drug Resistance Changes In Wendeng Osteopathic Hospital From 2009 To 2014

Objective In order to provide the scientific basis for reasonable choice of antibiotics and reduce drug resistance of bacteria,we analyzed the composition and resistance of pathogenic bacteria and its trend from January 2009 to December 2014 in the microbiology laboratory of Shandong Wendeng Orthopedic and Traumatic Hospital.Methods A retrospective survey was conducted to the pathogenic bacteria isolated in the microbiology laboratory of the hospital from January 2009 to December 2014.The bacteria isolated from January 2009 to December 2011 were divided into group A,and those isolated from January 2012 to December 2014 were divided into group B.the pathogenic bacteria were identified and the antibiotic susceptibility was detected by VITEK-2 compact automated microbiology system,the data was analyzed by SPSS 12.0 software.Result(1)A total of 3392 non-repeated strain was isolated during the six years.Among them,Gram positive bacteria accounted for 33.05 %(1121/3392),Gram negative bacteria accounted for 62.88 %(2133/3392).the fungi accounted for 4.07%(138/3392).Of the Gram positive pathogens,Staphylococcus aureus accounted for 49.15%(555/1121),Staphylococcus epidermidis was 19.45%(218/1121),and Enterococcus faecalis 7.85%(88/1121).Of the Gram negative pathogens,Klebsiella pneumonia accounted for 15.56%(332/2133),Enterobacter was 15.00%(320/2133)and Escherichia coli 14.39%(307/2133).(2)Compared with group A,the number of pathogenic bacteria in group B was increased,while there were no significant changes in the constituent ratio of Gram positive bacteria,the top three strains were Staphylococcus aureus,Staphylococcus epidermidis and Enterococcus faecalis.But the constituent ratio of Gram negative bacteria changed,E.coli,Klebsiella pneumoniae subspecies pneumonia and Pseudomonas aeruginosa were dominant in group A,while Enterobacter cloacae,Klebsiella pneumoniae subspecies pneumonia and Escherichia coli were dominant in group B.(3)Among the majority of Gram positive bacteria,Staphylococcus aureus and Staphylococcus epidermidis showed lower drug resistance,and there were more antibiotics to be available.The drug resistance of Enterococcus faecalis was serious,only teicoplanin,vancomycin and nitrofurantoin maintained high sensitivity to most of the Gram positive pathogens.Vancomycin-resistant Staphylococcus aureus was not found.(4)In the Gram negative pathogens,Enterobacter cloacae showed lower drug resistance and more than 80% of the antibiotics could be chosen.Escherichia coli was resistant to most of the antibiotics with a resistant rate over 50% and a few antibiotics to be available.Some antibiotics such as amikacin,piperacillin/tazobactam and imipenem maintained high sensitivity to the majority of Gram negative bacteria.Conclusion: Gram negative bacteria were the dominant isolates from January 2009 to December 2014 in our hospital.The situation of drug resistance was still serious although the drug resistance of most bacteria decreased.Clinical attention should be paid to the identification of pathogens and antibiotic susceptibility so as to choose and use antibiotics reasonably.