Distribution And Drug Resistance Analysis Of Bacterial Separated From The Department Of Intensive Medicine In A Third Class A Hospital

Objective:To investigate the distribution and drug resistance of bacteria isolated from the Department of Intensive Medicine in a third Class A Hospital,and to provide theoretical basis for the rational use of antimicrobial agents and prevention and control of nosocomial infection in clinical science.Methods:The distribution of bacterial etiology and the results of drug sensitivity test were analyzed retrospectively from May 2018 to April 2020.All specimens collected were divided into two groups,from May 2018 to April2019 as group 1,and from May 2019 to April 2020 as group 2.Results:(1)From May 2018 to April 2020,2596 specimens were submitted to the Department of Intensive Medicine of a third Class A Hospital.The positive rate of bacterial etiology in the two groups was significantly lower than that in the first group.The difference was statistically significant(χ~2=11.57,P=0.001).(2)The distributions of bacteria was mainly Gram-negative bacilli.Compared with the two groups,the positive separation rate of each bacteria was not statistically significant.(3)The main source of the specimen was respiratory tract(72.26%),followed by blood and urinary tract,which accounted for 9.67%and 5.09%of the samples.The urinary separation rate in the second group was significantly higher than that in the first group(χ~2=13.746,P<0.001),and the ascites separation rate in the second group was lower than that in the first group(P<0.001),and the number of the remaining specimens was not statistically significant.(4)Acinetobacter baumannii’s resistance to carbapenems>70%in non-fermented gram-negative bacilli,between 38.71%～42.11%,Acinetobacter baumannii and Pseudomonas aeruginosa>90%resistance to cefixime.Comparison of drug resistance between the two groups,increased resistance of Acinetobacter baumannii to piperacillin/tazobactam,differences were statistically significant(χ~2=17.049,P<0.001),decreased resistance to tegacyclin,differences were statistically significant(χ~2=4.145,P=0.042).Pseudomonas aeruginosa increased resistance to cefepime,differences were statistically significant(χ~2=20.067,P<0.05),the resistance to myxins decreased,differences were statistically significant(P=0.036).Clebsiella pneumoniae resistant to cefuroxime ester was 100.00%in Escherichia coli producing broad-spectrumβ-lactamase,drug resistance rates of ceftriaxone,cefotaxime,ceftazidime>90%,drug resistance to carbapenem≥60%.In contrast,Klebsiella pneumoniae,cefuroxime(P=0.009),levofloxacin(χ~2=10.940,P=0.001)Increased resistance,the difference was statistically significant.On cotrimoxazole(P=0.001),aztreonam(χ~2=5.494),P=0.019,Amikacin(χ~2=6.537,P=0.011),tegacycline(P=0.047)drug resistance decreased,the difference was statistically significant.The drug resistance rates of cefoxitin,and cefotaxime were 100.00%.Compare the two groups,the change of drug resistance rate was not statistically significant.The resistance rates of Escherichia coli to cefuroxime,ceftriaxone and cefotaxime were 100.00%,drug resistance to carbapenem<20%.In contrast,the resistance rates of Escherichia coli to cefuroxime(P=0.043),cefoxitin(P=0.006)and cotrimoxazole(P=0.001)increased,the difference was statistically significant.(5)Staphylococcus aureus,and Enterococcus faecium were 100%resistant to penicillin,while Staphylococcus and Enterococcus were zero.Conclusion:(1)The distribution of bacteria isolated from the Department of Critical Care Medicine in our hospital is mainly gram-negative bacilli.The top six detection rates were Acinetobacter baumannii,Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,Naromonas,mycoius.(2)Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and S.cerevisiae were all multidrug resistant bacteria.Control of Gram-negative bacilli infection in respiratory tract was the main problem to be solved.Continue to strengthen hospital sense control,as soon as possible specimen etiology detection,so as to use antibiotics as early as possible according to the results of drug sensitivity,to curb the progress of infection.