Analysis Of The Distribution And Drug Resistance Variance Of Pulmonary Infection-Related Pathogen In Respiratory Department Of Our Hospital During 2007-2009

Objective: To investigate the distribution and drug resistance of pulmonary infection-related pathogen in respiratory department of our hospital during 2007-2009 .Methods: Describe the distribution of the pathogens isolated from the sputum specimens and bronchoalveolar lavage fluid specimens of 4119 patients who was diagnosed as pulmonary infection in our respiratory department during January 2007 ~ December 2009, investigate the drug sensitive of the top five of clinical common gram-negative bacillis to 14 antibiotics commonly used in the three years, explore the drug-resistant change of clinical common gram-negative bacilli .Results: The survey shows that the ratio of sputum specimens cultivated was 50.3%, the ratio of bacteria separated was 29.8%,these ratio were both low.A total of 618 strains of pathogenic bacteria were isolated.Among them 393 strains were gram negative bacilli(63.6%),the top five gram negative bacilli were Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,Acinetobacter baumannii,Enterobacter cloacae.204 strains were fungus(33.0%),the main fungus were Candida albicans,and fungal infection rate showed an upward trend year by year.21 strains were gram positive coccus(3.4%),the main gram positive coccus were Staphylococcus and Enterococcus. Gram negative bacillis were highest sensitivity to carbapenem antibiotics-imipenem and meropenem, followed by the complex ofβ-lactamase- sulperazone(cefoperazone/sulbactam) and Tazocin(piperacillin/ tazobactam ), and then amikacin. The resistant ratio to sulfonamides antibiotics-cotrimoxazole,penicillins antibiotics- piperacillin,the third generational cephalosporine- cefotaxime,quinolones antibiotics-ciprofloxacin and levofloxacin were very high. From 2007 to 2009, antimicrobial drug resistance had a increasing trend year by year. The most obvious increase in drug resistance were cephalosporine,quinolones antibiotics and monocyclicβ-lactam antibiotics-aztreonam, one of the main reasons was that they are widely used in clinical. 2009,a total of 27 strains of ESBLs-producing,include of Klebsiella pneumoniae was 16 strains and Escherichia coli was 11 strains,the isolating rate of 43.2% and 47.8%. Klebsiella pneumoniae and Escherichia coli were predominant strain of ESBLs-producing.The drug resistant of ESBLs-producing strains was much higher than non-ESBLs-producing strains.Conclusion: Gram negative bacilli were major pathogens causing pulmonary infection in respiratory department of our hospital . Clinical common gram negative bacilli have different levels of resistance to antimicrobial agents, resistance rates were generally high, and there is an upward trend year by year; clinician should master the latest development of the pathogens and drug resistance in the region,choose antimicrobial agents suitably; should be fully aware that it is very important to select antimicrobial agents suitably for the treatment according to the results of continuous surveillance of antimicrobial resistance.