Distribution And Drug Resistance Patterns Of Pathogenic Bacteria From Sputum Culture Of Patients In Neurological Intensive Care Unit

Objective:To investigate distribution and drug resistance patterns of pathogenic bacteria by sputum culture from patients in the neurological intensive care unit(NICU),and to provide evidence for clinical empirical therapy.Methods: 97 NICU patients with sputum bacterial culture at the First Hospital of China Medical University from January to December 2018 were enrolled.Among them,86 patients with positive result of sputum bacterial culture and completed drug sensitivity test.Those who obtained one pathogen were enrolled in the single-bacterial detection group;two or more pathogens were included in the multi-bacterial detection group;and11 patients with negative results were selected in the control group.The results of sputum bacterial culture and drug sensitivity test,general conditions,and hospitalization information of these patients were collected.Software including EXCEL and SPSS 20.0were applied to analyze the distribution and drug resistance patterns of pathogenic bacteria from NICU patients' sputum bacterial culture.Results: There were 86 cases with positive sputum bacterial culture and completed drug sensitivity test.A total of 191 pathogens were isolated,160 strains(83.77%)of Gram-negative bacteria and 31 strains(16.23%)of Gram-positive bacteria.The distribution of pathogenic bacteria among different diseases is not identical.Acinetobacter baumannii is the predominant pathogen in sputum culture of patients with cerebrovascular disease and Guillain-Barre syndrome.Pseudomonas aeruginosa is the main pathogen in patients with intracranial infection,autoimmune encephalitis,myasthenia gravis and myasthenia syndrome.Klebsiella pneumoniae is the major pathogen detected in patients with hypoxic encephalopathy.Moreover,the duration of mechanical ventilation and hospitalization is longer in patients with multi-bacterial detection than patients in single-bacterial detection group.Drug sensitivity test results have revealed that tigecycline,amikacin,and cefoperazone/sulbactam have lower drug resistance rates to Acinetobacter baumannii,and Pseudomonas aeruginosa is less resistant to common third and fourth generation cephalosporins,antibiotics combined with beta-lactamase inhibitors and aminoglycoside antibiotics.Klebsiella pneumoniae is resistant to most antibiotics,but no Klebsiella pneumoniae strain resistant to tigecycline was found.In this study,no strains of Staphylococcus aureus resistant to linezolid,gentamicin,nitrofurantoin,rifampicin,teicoplanin,quinuprisitin/dalfopristin,vancomycin and tigecycline were found.Conclusion: 1.The pathogens isolated from NICU patients' sputum bacterial culture are mainly Gram-negative bacteria;2.The main pathogens detected in patients with different diseases are not identical;3.The duration of mechanical ventilation and hospitalization is longer in patients with multi-bacterial detection.