Study On Distribution And Drug Resistance Of Common Multi-drug Resistant Bacteria In A Hospital

Objective:To analyze the distribution characteristics and drug resistance changes of common multi-drug resistant bacteria through a retrospective study of common multi-drug resistant bacteria isolated from a top three hospital in the past five years(2014.1-2018.12),and to rationally use the relevant clinical departments of the hospital.Provide reference for antibacterial drugs and to reduce nosocomial infections and prevent infection outbreaks.Methods:Multi-drug resistant strains isolated from clinical specimens from January to December 2018 in a third-grade general hospital in Yan'an were studied,and basic information such as age,gender,department,specimen,and drug sensitivity test results were recorded.Comprehensive sample information was used to analyze the distribution characteristics and drug resistance changes of multi-drug resistant bacteria.This paper mainly uses SPSS20.0 spreadsheets for data analysis and research.Results:1.A total of 834 strains of common multidrug-resistant bacteria were isolated in the hospital in the past 5 years,of which ESBLs-producing Escherichia coli accounted for the largest proportion(359 strains,43.05%);methicillin-resistant Staphylococcus aureus 224 strains,the proportion was 26.86%;a total of 128 multi-drug resistant Acinetobacter baumannii,the proportion is 15.35%;the number of changes in 5 years decreased first and then increased.Among the gender and age distribution,male patients were the most common,31-80 years old accounted for the most;the main three types of specimens were sputum specimens,accounting for 35.01%;secretions,the proportion was 22.66.%;urine,the proportion of 15.89%;intensive care medicine is the main department of multi-drug resistant bacteria,the proportion is 26.02%.2.ESBLs-producing Escherichia coli are mainly distributed in oncology and nephrology,and most of them are detected in urine samples.It has high resistance to cephalosporins,ATM,and penicillins,and is highly sensitive to carbapenems,AN,and TZP.3.Methicillin-resistant Staphylococcus aureus is mainly isolated from the secretion specimens of the Nasopharyngeal and Burn Plastic Surgery Hand Surgery and is completely sensitive to VA,LZD and TGC.The antibiotics with high drug resistance rate are DA,ERY,TCY,and these antibacterial drugs have poor effects in the treatment of MRSA infection.The resistance rate of quinolones is between 16.6% and 42%,and the resistance to RD,GM,SXT and QDA is low.4.Multidrug-resistant Acinetobacter baumannii is mainly isolated from sputum specimens of patients in intensive care medicine.It has high resistance rate to most antibiotics,and the overall resistance rate to AN is less than 32%.It shows different MEM and IMP.Degree of resistance.5.ESBLs-producing Klebsiella pneumoniae is mainly isolated from patients with intensive care medicine.The resistance rate to AN,GM,and TM is less than 40%,but the resistance rate of GM in the past 5 years is increasing year by year.The resistance rate of TZP(7.9%)was lower than that of SAM(94.5%).The resistance rates of ESBLs-producing Klebsiella pneumoniae to PRL,CZO,CAZ,CTT,CXM,CRO,and FEP were all greater than 60%,the resistance rates to LVX and CIP were 30% to 80%,and the resistance of SXT was 5 years.The drug rate is greater than 60%.6.The multidrug-resistant Pseudomonas aeruginosa was mainly distributed in the intensive care medicine department and neurosurgery.The most common samples were found in the sputum specimens.No colistin(COL)-resistant strains were found,and the resistance rates to AN,TM,and GM were yearly.The upward trend is more than 90% for the third-generation cephalosporin antibiotics(CRO,CAZ).The resistance rate to carbapenems(IMP,MEM)increased year by year,the resistance rate of levofloxacin(37.1%)was lower than that of ciprofloxacin(88.7%),and the resistance rate of SXT was always higher.The resistance rate of penicillins/enzyme inhibitors(SAM,TZP)was between 62% and 100%.Conclusion:The 834 strains of common multi-drug resistant bacteria isolated in this hospital in the past five years are most common in ESBLs-producing Escherichia coli in Gram-negative bacteria,and the most resistant to methicillin-resistant Staphylococcus aureus in Gram-positive bacteria;common multiple resistance The number of detected bacteria in the past 5 years decreased first and then increased;Gram-negative bacteria showed high resistance to penicillins,monocyclic ?-lactams and cephalosporins;Gram-positive bacteria have not yet appeared on the eternal A strain resistant tomycin.Therefore,it is recommended to strengthen the training of clinical medical staff,improve the awareness of pathogenic diagnosis,rationally select antibiotics based on drug susceptibility results,thereby slowing the occurrence of drug resistance and avoiding the prevalence of multi-drug resistant hospital infections.