Analysis Of Bacteria Distribution And Antibiotic Resistance In Lower Respiratory Tract Infection In Respiratory Department Of Our Hospital During The Year Of 2006～2008

Nowadays, with the ceaseless appearance of antibiotic drugs, the morbidity and mortality of lower respiratory tract infection are still at a high level. Because of the extensive applications or not fitting usages of antibiotics, antibiotic resistance also has been enhanced; some special drug-resistance bacteria such as multidrug resistant have appearance. The emergence of the antibiotic resistance and the infection of the resistant bacteria usually results in the defeat of experiential diagnoses and therapies, which brings a tremendous challenge to the therapy of anti-infection in clinic. In order to assess the status of familiar pathogen and resistance to antibiotics in clinic presently, offer referential suggestion for doctors to choose antibiotic drugs suitably, treat the infective diseases effectively and control the spread of the resistance, 1556 cases of lower respiratory tract infection were analyzed retrospectively in respiratory department of our hospital during the period of 2006-2008.The phlegm cultivation amount is 494, bred and separated 109 bacteria; the check rate is 45.3%. There were 32 Gram Positive Bacteria, which had a rate of 14.4% in all infection germane; and 77 Gram Negative bacteria, which had a rate of 34.3%, the main bacteria are Klebsiella Pneumonia bacteria, Escherichia coli, and Verdigris Pseudomonas; 115 eumycete which had a rate of 51.3%, the main are yeast fungus, Candida albicans. Klebsiella Pneumonia bacteria's number is 24 having a rate of 14.7%, Escherichia coil's number is 13 having a rate of 5.8%, Genus Enterococcus's number is 8 having a rate of 3.5%, and yeast fungus's number is 80 having a rate of 35.7%. A total of 19 strains of ESBLs-producing, the isolating rate of 24.8%, include of Escherichia coli were 6 strains and Klebsiella pneumonia was 11 strains, the isolating rate of46.2% and 45.8%. Escherichia coli and Klebsiella pneumonia were predominant strain of ESBLs- producing.Compare Gram Positive bacteria with Gram Negative bacteria, Gram Positive bacteria resistance ratio to Penicillium is 55.6%, Gram Negative Bacteria were resistant to majority of the second and third generational Cephalosporin, but the sensitivity to complex enzyme preparation was passable, and were sensitive to Quinolones and Amino glycosides antibiotics. Gram Positive bacteria's drug-resistance to the fourth generational Cephalosporin's antibiotics is high to the rate of 61.5%. Gram Positive bacteria and Gram Negative bacteria both had high drug-resistance toImipenem drug such as Meropenem.The research indicate the following conclusions: The ratio of sputum cultivated and the ratio of bacteria separated are still very low in clinic presently, so the doctors should make the best use of the microorganism laboratory to take the specimen to cultivate the pathogen and take the antimicrobial sensitivity test as early as possible, and the construction of the microorganism laboratory should be strengthened; The fungus infection is very serious presently, and the doctors should use antibiotic drugs suitably to avoid second infection or multi-infection and reduce the occurrence of fungus infection; so doctors should pain more attention to patients'bacterial status, such as Klebsiella Pneumonia bacteria, Escherichia coli, and Verdigris Pseudomonas,should notice their drug-resistance mechanism. We should select allergic antibiotics according to the drug-allergic experiments results, control the diseases as soon as possible, heighten cure rate, lighten patient's suffering, and adjust patient's body immunity state.However, because of being affected by many factors, the experienced usage of antibiotic drugs is still the main method of antibiotic therapy. What's more, the experienced therapy can't be replaced by the objective therapy in a period of time. Before acquiring the result of AST, doctors should make a project of using drugs suitably with the correct diagnosis of the disease, mastering the characters of antibiotic drugs, the epidemiologic research of the spectrum of pathogen and bacterial resistant inspection and random controlled test on the similar infection, and the experience of objective therapy before. For severe infection, de-escalation therapy is promoted, which advocate using the antibiotics of broad spectrum in the first stage in order to avoiding the deterioration of the disease, avoiding the bacteria creating antibiotic resistance, preventing the dysfunction of organs saving the patient's life and shortening the days of patient staying in hospital; and in the second stage, narrow spectrum antibiotics are used instead of the broad spectrum antibiotics in order to reducing the occurrence of bacterial resistance to antibiotics and making the optimization of cost and efficiency on the treatment. When the result of the AST is acquired, the antibiotic drugs should be adjusted in time according to the result.The above statement indicates that the research of the distribution of bacteria and the analysis of bacterial resistance is significant to mastering the general pathogen of infective disease and the status of bacterial resistance, guiding doctors to choose antibiotic drugs suitably and reduce the occurrence and spread of dug-resistant bacteria.