| Objective To understand the distribution and drug resistance of pathogenic bacteria of nosocomial infection in ICU and general wards,so as to provide guidance for anti-infection treatment in different clinical departments,promote clinical rational use of drugs and slow down the emergence of drug-resistant bacteria.Methods The clinical data of patients with nosocomial infection in our hospital from January 2017 to December 2019 were retrospectively analyzed.According to the source of the department,the patients were divided into ICU group and general ward group.The source of samples,bacterial species and drug sensitivity results of the two groups were recorded respectively.The data were entered into the EXCEL form and the data of the two groups were statistically analyzed by spss22.0 statistical software.The enumeration data were described in rate or constituent ratio,and the difference between the two groups of enumeration data was checked with chi-square.P<0.05 indicates that the difference is statistically significant.Results A total of 826 strains of pathogenic bacteria were isolated and cultured from2017 to 2019.Among them,154 strains were isolated from the ICU ward.Gram negative bacilli were the main pathogens,accounting for 80.52%,followed by Gram positive bacteria,accounting for 11.04%,and fungi,accounting for 8.44%.The top five bacteria were Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,Escherichia coli and Burkholderia cepacian;672 pathogenic bacteria were isolated from the general wards,of which Gram negative bacteria accounted for 74.25%,Gram positive bacteria accounted for 12.95%,and fungi accounted for 12.80%.The top five bacteria were Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Candida albicans and Staphylococcus aureus.In terms of specimen sources,sputum was the main source of ICU and general ward specimens,followed by urine and blood.In terms of bacterial resistance,the resistance rates of Escherichia coli to amikacin,cefotetan,carbapenems,nitrofurantoin,cefoperazone sulbactam and piperacillin tazobactam in the two groups were lower,less than 10%;The drug resistance rate of Escherichia coli isolated from ICU to cefepime was higher than that in general ward,and the difference between the two groups was statistically significant(P < 0.05).The drug resistance rate of Klebsiella pneumoniae to ampicillin,ampicillin sulbactam,ceftriaxone and cefazolin is higher,and the resistance rate is greater than 50% and the drug resistance rate of Klebsiella pneumoniae to ceftriaxone,cefoperazone sulbactam,ampicillin sulbactam,cefazolin and ceftazidime in ICU group was higher than that in general wards,and the difference was statistically significant(P < 0.05).The drug resistance rates of Acinetobacter baumannii isolated from ICU and general wards were generally serious,the drug resistance rate of Acinetobacter baumannii isolated from ICU to cefepime,imipenem,cefoperazone sulbactam,compound sulfamethoxazole and tobramycin was higher than that in general ward,with statistical significance(P < 0.05).The resistance rate of Acinetobacter baumannii isolated from the general ward to aztreonam was 100% greater than 73.33% in the ICU,and the difference between the two groups was statistically significant(P<0.05).Pseudomonas aeruginosa has a higher resistance rate to ampicillin and sulbactam,nitrofurantoin,and trimethoprim in the two groups,besides that the resistance rate to other common antibacterial drugs is about30% and there was no statistical significance in the drug resistance rates between the two groups(P > 0.05).Conclusion There is a difference in the distribution of pathogenic bacteria between ICU and general wards.The drug resistance rate of pathogenic bacteria infected in ICU is generally higher than that in general wards.Before clinical empirical medication,appropriate antibiotics should be selected based on the distribution characteristics of bacteria in each department to prevent the emergence of drug-resistant bacteria. |
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