| Objective1. To investigate the distribution of Pseudomonas aeruginosa and the change of drugresistance in Henan province Hospital of Traditional Chinese Medicine from2009to2013, for the purpose of providing basis for clinical antibiotic selection.2. Through the analysis of the risk factors of Pseudomonas aeruginosa to multi drugresistance, eventually by statistical method to analyze the related risk factors of multipledrug resistance, and provide the basis for the clinical prevention of multidrug resistantstrains.3. To resrarch the metallo beta lactamase (referred to as the metal enzyme, MBL)migration changes of Pseudomonas aeruginosa of Henan province Hospital ofTraditional Chinese Medicine during the5years.4. Through the national antimicrobial resistance monitoring network in Henan provinceand the national Pseudomonas aeruginosa drug resistance for comparative analysis, tounderstand the drug resistance level in our hospital.Methods1. A retrospective survey of infection and antibiotic resistance of Pseudomonas aeruginosaisolated from all kinds of clinical specimens in Henan province Hospital of TraditionalChinese Medicine from2009to2013, and statistical analysis was performed byWHONET5.6software.2. Utilized SPSS17.0statistics software, by2test,through the analysis of the data ofpatients, summarized record of age and sex, taked antibiotics time, whether usedtracheal intubation, deep vein catheterization, urinary catheter, whether there was awound, single factor analysis was carried out, to find out the risk factors associated withmultidrug resistant bacteria, P<0.05is to illustrate difference has statistical 3. significance.4. Use the MIC method to screen imipenem resistant (IPM) and/or meropenem (MEM)strains.5. Through screening by E-test production MBL in resistant IPM or MEM strains.Results1. In this study,478strains were isolated, mainly from sputum specimens,82.0%(392/478), followed by wound secretions, accounted for10.9%(52/478), urineaccounted for4.4%(21/478), blood1%(5/478). Samples were mainly from ICU andlung disease ward.2. The most sensitive was Cefoperazone/sulbactam, followed by Amikacin, imipenem,piperacillin/tazobactam, cefepime, imipenem; the highest resistance rate to ampicillin,ampicillin/sulbactam, followed by cefotetan, cefazolin, cefuroxime axetil, cefuroximesodium, cotrimoxazole, were all above95%in the frequently used antibiotics.3. Through statistical analysis, the age of patients, the long time use of antibiotics, whetherused immunosuppressive agents，whether uesd tracheal intubation or deep venouscannula，and whether there was a wound were correlated to the multidrug resistantstrains；and the patients gender, whether suffered from tumor, whether used the urinarycatheter was not obviously related to the multidrug resistant isolates.4. From2009to2013, resistant to imipenem and meropenem was respectively18.3%and12.1%;32.2%and21.7%;25.8%and23.1%;32.8%and23.1%;38.4%and26.7%,and the MIC value increased at different degree.5. By E-test screening produced metal enzyme strains from imipenem resistant and/ormeropenem strains, respectively33.3%(3/9),45%(9/20),55.6%(10/18),58.1%(25/43),64.6%(42/65).Conclusion1. Pseudomonas aeruginosa isolates had increased year by year, distributed conditionroughly the same, mainly from ICU and lung disease endemic area, this was consistentwith reports in the literature, multidrug resistant strains isolated from ICU is mostlylower respiratory tract and bronchial drainage specimen, and samples of urine and bloodof sterile fluid sensitivity of antibiotics still very high.2. Resistant to imipenem and meropenem were increased, which brings great difficulties tothe clinical treatment.3. The age of patients,the long time use of antibiotics,usd tracheal intubation or venouscannula and other factors were related to multidrug resistant. 4. Compared with the national antimicrobial resistance monitoring network(http://www.mohnarin.org) to2013data of drug resistance in our hospital, the rate ofresistance to meropenem was27.5%,5.8%lower than Henan province level,andbasically the same as the resistance level22.7%in entire country.5. MBL PA increased year by year, incriminated the abuse of antibiotics, hospital onset ofinfection such as increased invasive procedures. |
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