Analysis About The Pathogen Distribution And Antibiotic Resistance Of Bacteria In The Patients With AECOPD In2007and2011

Objective：Retrospective analyzed our hospital patients with acute exacerbation ofCOPD airway secretion samples pathogen distribution and the rate of bacterialresistance, providing a reference for the AECOPD patients used antibiotics.Method: Systemic retrospective analysis the respiratory ward AECOPD patientsin Liao Ning Province People’s Hospital airway secretions separation of211and186strains of pathogenic bacteria distribution and drug resistance, form January2007toDecember2007and from January2011to December2011.Using the BD PHOENIXautomatic microbial identification/susceptibility system to identification the bacterialstrains, and using the disc diffusion method for drug sensitive test.Results：1. In2007, a total of211strains bacteria were isolated. Gram-negativebacteria accounted for78.20%, the separation of the three bacteria: pseudomonasaeruginosa42strains, klebsiella pneumoniae,33strains, acinetobacter baumannii29strains, accounted for49.29%of the total. Gram-positive bacteria accounted for29.0%,of which17strains of staphylococcus aureus and6strains pneumococcus, account for10.9%of the total.17strains of fungi, account for8.06%of the total.2. In2011, a total of186strains bacteria were isolated. Gram-negative bacteriawere76.88%, the separation of the three bacteria: acinetobacter baumannii38strains,pseudomonas aeruginosa30strains, klebsiella pneumoniae23strains, account for48.92%of the total. Gram-positive bacteria12.9%, staphylococcus aureus15strains,pneumococcus3strains accounted for9.68%of the total. Fungus19strains, accountingfor10.22%of the total.3. In2007and2011, Pseudomonas aeruginosa resistance rate of more than50%:ampicillin/sulbactam, amoxicillin/clavulanic acid, ceftriaxone. The resistance wasmaintained below30%of antibiotics: imipenem, meropenem, amikacin, gentamicin. The Polymyxin the sensitivity of100%. Comparison with2007, in2011Pseudomonasaeruginosa to the common beta-lactams, quinolones resistance rates increased resistancerates increased by more than10%: ceftriaxone, ciprofloxacin lactate star.4. In2007and2011, Klebsiella pneumoniae resistance rate of more than50%: ampicillin/sulbactam, ciprofloxacin, levofloxacin. The resistance was maintained below30%of antibiotics: gentamicin, imipenem, meropenem and cephalosporin cefepime. The Polymyxin the sensitivity of100%. Compared to2007, in2011Klebsiella pneumoniae to the common beta-lactams, the majority of quinoloneantibiotic resistance rate was significantly higher resistance rates increased by more than10%: ampicillin/sulbactam, amoxicillin amoxicillin/clavulanic acid, piperacillin/tazobactam, ceftazidime, cefepime, ceftriaxone, aztreonam, ciprofloxacin,levofloxacin.5. In2007and2011, Acinetobacter baumannii resistance rate of more than50%: ampicillin/sulbactam, amoxicillin/clavulanic acid, ceftriaxone, aztreonam,ciprofloxacin, levofloxacin. There is no resistance rates remain at less than30%of the antibiotics. The Polymyxin the sensitivity of100%. Compared to2007, in2011, Acinetobacter baumannii to the common beta-lactams, quinolones antibiotic resistance rate was significantly increased resistance rates increased by more than10%: amikacin, gentamicin, Asia imipenem, meropenem, cefoperazone/sulbactam, ceftazidime, ceftriaxone, aztreonam, levofloxacin.Conclusion:1.Our hospital patients with AECOPD pathogens was mainlyGram-negative bacteria, in2007and2011with bacterial isolates similar results,respectively78.20%and76.88%.2. Compared to2007, in2011the top three of our hospital patients with AECOPDPathogen rate changes, in two years the top three pathogens are: Acinetobacterbaumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae. But Acinetobacterbaumannii separation rate rose to first in2011.3. Compared to2007, separated in2011, Acinetobacter baumannii, Klebsiellapneumoniae, Pseudomonas aeruginosa to beta-lactams and quinoloness, the majority ofthe quinolone antibiotic resistance rate was significantly higher. Klebsiella pneumoniae,Pseudomonas aeruginosa to imipenem, meropenem, cefepime, amikacin, gentamicinresistance rates remain at30%. Acinetobacter baumannii resistance rates in addition topolymyxin more than30%in2011.4. Clinicians should pay attention to the detection of pathogens, understanding the region, the unit pathogen distribution and drug resistance, a reasonable choice ofempiric antibiotic.