Distribution And Drug Resistance Of Pathogens In Lower Respiratory Tract From 2011 To 2014 In ICU

Objective: To investigate the distribution and antimicrobial resistance of pathogens form lower respiratory tract in patients, in intensive care unit(ICU),so as to provide reference for clinical treatment.Methods: Distribution and antimicrobial susceptibility of pathogens isolated form ICU patients sputum obtained through fiberbronchoscope between 2011 and 2014 were analyzed retrospectively. The bacterial identication and the susceptibility testing were perfoed by means of VITEK02 compact automatic identification system,drug sensitive test were according to the CHINET.Results: The total number of pathogens is 3454 strains were isolated between January 1,2011 to December31,2014,the percentage of gram-negative bacteria, gram-positive bacteria,and the fungi were 84.11%, 14.50% and 1.39% respectively.The detection rates of extended-spectrum β‐lactamase-producing Klebsiella pneumoniae and Escherichia coli were 38.46% and 33.64% in 2011,48.39% and 37.06% in 2012,51.52% and 26.95% in2013,73.33% and 36.96% in 2014, Enterobacteriaceae strains had low resistance to imipenem and meropenem(?20.00%); Gram-negative bacteria were detected in the highest rate of non-fermentative bacteria, resistance of Acinetobacter baumanii was higher than Pseudomonas aeruginosa,both the bacteria were low resistant to amikacin(3.32%-37.16%),vancomycin and linezolid resistant strains were not found among Staphylococcus.Detection rates of methicillin-resistant staphylococcus aureus(MRSA) were 61.22% in 2011,48.15% in 2012,42.86% in 2013 and 48.05% in2014;methicillin-resistant coagulase-negative staphylococcus(MRCNS) were 86.96% in2011, 87.10% in 2012, 91.67% in 2013, 88.37% in 2014;resistance rates of Enterococcus faecium was higher than Enterococcus faecalis, only a few of linezolid resistant Enterococcus faecalis and all the Enterococcus faecium were sensitive to linezolid,vancomycin-resistant strains were not found among Enterococcus faecalis andEnterococcus faecium;Candida albicans was the main type of fungi.Conclusion:Antimicrobial of pathogens isolated form lower respiratory tract is getting more serious and The problem of multidrug resistance is growing trend.clinicians should pay attention to non-antimicrobial infection control strategies in addition to rational use of antimicrobial agents.