Bacteria Distribution And Drug Resistance Analysis Of Patients With Blood Culture Positive

Objective: To analyze bacteria distribution and drug resistance analysis of patients with blood culture positive in respiratory and critical care of our hospital, provides reference for clinical rational use of antimicrobial agents.Methods:Collected between January 2012 and December 2014, ningxia medical university general hospital respiratory and critical care, 105 cases of hospitalized patients with bacterial blood culture positive for data, retrospective analysis of 105 patients with positive blood culture pathogens in front of the age, sex, blood temperature, hospitalization date, basic diseases, inflammatory factor index, whether intubation and breathing machine auxiliary treatment, prognosis and other general information, as well as pathogenic bacteria distribution and drug susceptibility. Application SPSS17.0 statistical software for statistical analysis.Result: There are 105 strains of blood culture positive for pathogenic bacteria, including gram-positive bacteria 53 strains, accounting for 50.48%, and 52 strains of gram-negative bacteria, accounting for 49.52%.The most common separation of bacteria followed by 33 strains of coagulase negative staphylococcusc(31.43%), 22 strains of e.coli(20.95%), 17 strains of acinetobacter baumannii(16.19%), 11 strains of staphylococcus aureus(10.48%), 9 strains with klebsiella pneumoniae(8.57%), 6 strains of excrement enterococcus(5.71%). Staphylococcus aureus bacterium is highly resistant to penicillin G and erythromycin, the drug-resistant strains of nitrofurantoin, linezolid, dalfopristin/quinupristin, tigecycline, vancomycin, teicoplanin are not found. The detection rate of MRSA and MRCNS are36.4%(4/11), 69.7%(23/33), and both are highly sensitivewith erythromycin, nitrofurantoin,linezolid, dalfopristin/quinupristin, tigecycline, vancomycin, teicoplanin, sensitive rate is 100%. Excrement enterococcus are not detected in drug-resistant strains of linezolid, dalfopristin/quinupristin, tetracyclines, tigecycline, vancomycin andteicoplanin,butto other subjects, drug resistant rate are above 60%. E.coli is highly sensitive to imipenem,followed by piperacillin/tazobactam,amikacin and nitrofurantoin, the sensitive rate are 95.7%、91.3%、90.9%. Klebsiella pneumoniae is completely resistant,to ampicillin and piperacillin, but highly sensitive to other subjects drugs(except with nitrofurantoin because of its sensitive rate was 44.4%). MDR of e.coli and klebsiella pneumonia bacillus are72.7%(16/22)、33.3%(3/9). Acinetobacter baumanniihave higher drugresistancepercentages of all kinds of antibacterial drugs, only sensitive to imipenem, amikacin co-trimoxazoleandminocycline,sensitive rate all below 50%, respectively 11.8%、29.4%、35.3%、42.1%.17 strains of acinetobacter baumannii, all are multiple drug-resistant bacteria, 12 strains of extensively drug-resistant bacteria, 5 strains of drug-resistant bacteria. Bloodstream infections in patients with an average age is(60.41±17.59), all have a fever, almost have higher blood leukocytes and neutrophils, ESR, CRP and PCT rising, and merging a variety of basic diseases. Mortality is 24.8%.Conclusion:1.In blood culture positive for bacteria, gram-positive bacteria is higher than the proportion of gram-negative bacteria, commonly isolated bacteria followed by coagulase negative staphylococcus aureus, e.coli, acinetobacter baumannii, staphylococcus aureus, klebsiella pneumoniae, excrement enterococcus. 2. There are not foundthe drug-resistant strains of nitrofurantoin, linezolid, dalfopristin/quinupristin, tigecycline, vancomycin, teicoplanin to staphylococcus aureus bacterium. The detection rate of MRSA and MRCNS are36.4% and 69.7%. 3. Enterobacteriaceae are highly sensitive to penicillium carbon alkene antibiotics, the sensitive rate are 100%, and having stronger antibacterial activity to β-Lactamaseinhibitors andaminoglycosides.MDR of e.coli and klebsiella pneumonia bacillus are 72.7% and 33.3%. 4. Acinetobacter baumannii resistant rate and fatality rate are all high, 11 strains of acinetobacter baumannii areall multiple drug-resistant bacteria, and 3 of them are drug-resistant bacteria. It is only sensitive to imipenem, amikacin co-trimoxazole and minocycline,sensitive rate all below 50%. 5. All bloodstream infections in patients have a fever, aimost have higher blood leukocytes and neutrophils, rising ESR、CRP and PCT and merging a variety of basic diseases.We must keep high vigilance against bloodstream infections occurred. 6. It is necessary to strengthen monitoring blood culture, clear its bacteria species and drug susceptibility, as a guidance to the rational use of antibiotics.