Distribution And Drug Resistance Of Pathogens In Lower Respiratory Tract Infection

Objective : To investigate the distribution and drug resistance of pathogenic bacteria causing lower respiratory tract infections in Qingdao Municipal Hospital(Group) and provide evidence for the rational use of antimicrobial drugs and to reduce the generation and spread of resistant strains.Methods: The pathogenic bacteria were cultured from a variety of specimens obtained from the lower respiratory tract infection patients in Qingdao Municipal Hospital(Group) between Jan 2012 and Dec 2013, the identification of bacteria and drug sensitivity test were carried out by VITEK-2 Compact automatic microbiolgy system. Confirmatory test of extended spectrum β-lactamases(ESBLs) were conducted by the double disk diffusion method. The data was analyzed by WHONET 5.6 Software.Results: A total of 1252 strains of pathogens were isolated, 57.8% from the department of respiration, 15.3% from ICU and 13.5% from neurology. Gram-negative bacilli accounted for 62.5%(783/1252), Gram-positive cocci were 33.4%(418/1252), and fungi 4.1%(51/1252). The top five pathogens were P. aeruginosa13.4%(168/1252), E. coli11.9%(149/1252), K.pneumoniae10.9%(137/1252), S. aureus10.1%(126/1252) and A. baumannii 9.3%(116/1252). The prevalence of ESBLs producing strains were 56.4% and 38.7% in E. coli and K. pneumoniae respectively,the drug resistance rate of Gram-negative bacilli to penicillin and cephalosporin were higher, but sensitive to imipenem, the drug resistance rate of ESBLs producing strains were significantly higher than that of non-ESBLs producing strains. S. aureus remained highly sensitive to vancomycin and teicoplanin, but showed high resistance to other antibiotics.Conclusion: The Gram-negative bacilli were the major pathogenic bacteria causing lower respiratory tract infections, and it shows multi-drug resistance, clinician should pay more attention to the drug resistance.