Survey Of The Pathogenic Bacteria And Analysis Of The Risk Factors Of Infection From2008to2011in Respiratory Intensive Care Unit In Xijing Hospital

Objective:Investigation into classification and resistance to antibacterial drug ofnon-repetitively clinical isolated pathogen and analyzing risk factors ofnosocomial infections in respiratory intensive care unit aim to improveaccuracy and effectiveness of empirical use of antibacterial drug, to reduce theprevalence of drug-resistant strains and to provide bases for control overepidemic of nosocomial infections.Methods:Collected the non-repetitively clinical isolated pathogens in respiratoryintensive care unit of Xijing hospital from2008to2011, and to run drugsensitive test, ESBLs test and MRSA test according to CLSI standard, then to analyze classification and resistance to antibacterial drugs of pathogenicbacteria. We also collected clinical data such as patient’s age, length of stay,underlying disease, mechanical ventilation, other invasive examinations andtreatments, use situation of antibacterial drugs, use situation of glucocorticoidsand immunosuppressant, then to analyze risk factors of nosocomialinfections.Results:1.1072non-repetitive strains were isolated in patients of RICU from2008to2011. The first three clinical isolated pathogens were Acinetobacterbaumannii, Staphylococcus aureus and Pseudomonas aeruginosa every year.2.Species within the Enterobacteriaceae family have lower sensitivity toβ-lactamases antibiotics and quinolones, and have higher sensitivity toaminoglycosides antibiotics and carbapenem antibiotics.3.The resistance to β-lactamases antibiotics was increased in non-fermentativebacteria. The non-sensitivity to carbapenem antibiotic was also increased inAcinetobacter baumannii, and there was no change in sensitivity tocarbapenem antibiotics in Pseudomonas aeruginosa.4.There was no Staphylococcus aureus strains resistant to vancomycin andteicoplanin,but2.1%Staphylococcus aureus was resistant to linezolid in2010.5.From2008to2011, the detection rate of ESBLs was100%in E. coli, and itwas95.5%in Klebsiella pneumoniae. The detection rate of MRSA inStaphylococci was more than90%.6.Lower respiratory tract infection (LRTI) was more frequent in nosocomialinfections in RICU. Incidence rate of urinary tract infection was less than LRTI. The third one was blood infection.7.Logistic regression analysis indicate that LOS(OR﹦23.00,95%CI﹦19.99-25.01), mechanical ventilation(OR﹦4.46,95%CI﹦3.58-6.34) andcombined use of antibacterial drugs(OR﹦7.01,95%CI﹦6.53-9.12) werestatistically significant(P＜0.05).Conclusion:1.Gram-negative bacillus were the major pathogens in RICU from2008to2011.2.Detection rates of ESBLs and MRSA were very high. This is a big challengeto anti-infection therapy.3.LOS, mechanical ventilation and combined use of antibacterial drugs wererisk factors of nosocomial infections in respiratory intensive care unit ofXijing hospital.