Distribution And Drug Resistance Of The Main Pathogens From Clinical In Liao Cheng Area

Objective1. To inestigate the proportion and distribution of the main pathogenic bacteria, with a distribution including gender,age,specimen and clinical department,etc in liao cheng area.2. To know the detection rate of ESBLs-producing Escherichia coli and klebsiella pneumoniae and Methicillin-resistant staphylococcus aureus (MRSA).3. Compared the drug resistance rate of the dominating gram-negative bacillus in different groups.4. To analysis the resistance rates of the main pathogens to common antibiotics.5. Compared the resistance rates to common antibiotics of ESBLs-Producing Escherichia coli and klebsiella pneumoniae straints with that of non-ESBLs-producing strains.6. Compared the resistance rates to common antibiotics of MRSA with that of MSSA.7. To know the change of the drug resistance rate that the main pathogens were isolated in clinical.Methods1. Specimen collection This study collected all kinds of specimens, including sputum、urine、blood wound secretion and ect in liao cheng area from May 2011 to May 2014.2. Laboratory tests2.1 Strain identificationThe straints cultivation and isolation were operated with the methods described by The National Clinial Laboratory Operational Regulations.The strains were identified by using the automatic microorganism analyzer VITEK2-compact. The quality control strains which klebsiella pneumoniae700603, Escherichia coli ATCC25922, Staphylococcus aureus ATCC25913, Pseudomonas aeruginosa ATCC27853 were supplied by the clinical laboratory center in Shandong province.2.2 Drug sensitivity test2.2.1 Antibiotic susceptibility test was made by using susceptibility system of the automatic microorganism analyzer VITEK2-compact card.2.2.2 ESBLs and MRSA were detected by the K-B paper methods.3. Statistical analysisThe date were analysed with WHONET5.6 and SPSS 13.0 software. The comparesion of the resistant rate adopped the chi-square test or fisher’s exact probability method. It was considered statistically significant to P<0.05.Results1. Totally 1292 strains were isolated from May 2011 to May 2014 in liao cheng area, there were 1122 strains of gram negative bacterium which accounted for 86.8%,170 strains of gram-positive cocci accounted forl3.2%.The top five in 1292 strains isolated pathogenic bacteria were Klebsiella pneumonia (31.1%), followed by Escherichia coli(27.9%),pseudomonas aeruginosa (16%), Acinetobacter baumannii(11.8%),Staphylococcus aureus(18.01%),pseudomonas aeruginosa (14.15%)2. The pathogenic bacteria from the age and gender are mainly distributed in elderly male patients over 65 years of age (60.1%), the ratio of male and female was 1.4:1; from the distribution of specimen, mainly sputum (65.9%), followed by urine and pus were 11.1% and 11.3%; from the distribution of departments, klebsiella pneumoniae mainly distributed in the intensive care unit; Escherichia coli mainly distributed in the medical ward and a surgical ward.3. The detection rates of ESBLs-producing Klebsiella pneumoniae arid Escherichia coli were 39.1% and 60.6% respectively. They showed a decreasing trend in three years.Methicillin-resistant staphylococcus aureus detection rate was 42.4%.4. The resistant rate of negative bacilli to Amikacin, Imipenem and Piperacillin/ tazobactam were less than 20%, but to Aztreonam, Ampicillin, Cefazolin, Cefuroxime and Ceftriaxone were more than 30%. Imipenem in all categories of resistance is the lowest, but Ampicillin resistant rate is the highest in all groups. There was a statisitical difference between ESBLs-producing strains and non-producing ESBLs strain except imipenem,amikacin, and and SMZ-TMP (P<0.05). The drug resistance rates of Staphylococcus aureus to tigecycline, vancomycin and linezolid were zero, to nitrofurantoin was 0.6%,to several other antimicrobial were 30-60%.5. The drug resistance rates of Klebsiella pneumoniae to nitrofurantoin, cefuroxime,ceftriaxone aztreonam mpicillin/Shubatan changed greatly (P<0.05), The drug resistance rates of Escherichia coli to Cefepime, cefuroxime, ceftazidime changed greatly (P<0.05),but Klebsiella pneumoniae and Escherichia coli in the rest of the several kinds of antibiotic drug resistance rate of change were not obvious (P>0.05). Acinetobacter baurnannii drug resistance rates showed a rise tendency as a whole. Although Pseudomonas aeruginosa to ampicillin/sulbactam, nitrofurantoin, cotrimoxazole, ceftriaxone, ceftazidime, cefuroxime resistant rate changed little, but has been very high status, and Amikacin resistance rate changes greatly decreased from 16.7%to 0 (P<0.05). The drug resistance rates of Staphylococcus aureus to tigecycline, vancomycin and linezolid rate have been zero in the past three years, but to cotrimoxazole showed an upward tendency (P<0.05), to several other antimicrobial resistance rates decreased linearly (P<0.05).Conclusion1. The pathogens isolated from clinic in Liaocheng were maining gram-negative bacilli, followed by gram-positive bacilli.The top five strains were klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baurnannii.2. In patients infected with the top five pathogens,elderly males over the age of six-five were dominating ones.The specimens isolated bacteria were mainlu sputum,followed by urine and pus. Among all departments,ICU,medicine and surgerg were much more than others.3. In liao cheng area ESBLs-producing klebsiella pneumoniae and Escherichia coli were still serious, And methicillin-resistant staphylococcus aureus also should cause enough attention.4. Gram-negative bacilli was highly resistant to Monobactam,penicillins and the first,second and third cephalosporins, but remained highly sensitivet to Amikacin, Piperacillin/tazobactam and Imipenem. Enzyme production strains resistant to antibiotics were higher than that of no enzyme producing strain.Staphylococcus aureus showed multi-drug resistance to many kinds of antibiotics. All isolates of staphylococcus aureus were sensitive to vancomycin, linezolid and Tigecycline.5. The drug resistance rate of Klebsiella pneumoniae and Escherichia coli had no significant change, but Acinetobacter baumannii showed a rise tendency as a whole. Resistant Pseudomonas aeruginosa rate changed little, but has been very high status. The drug resistance rate of Staphylococcus aureus changes showed a downward trend.