Resistant Analysis Of Pathogens In Patients With Community Acquired Pneumonia And Nosocomial Pneumonia In Vitro

Objective: To investigate the distribution and drug susceptibility of pathogens in patients with community acquired pneumonia(CAP) and hospital acquired pneumonia(HAP) in the First People’s Hospital of Hefei in last three years. This study was mainly performed to guide the clinical medication, and therefore, improve the treatment for CAP and HAP.Methods: The hospitalized patients in Hefei First People’s Hospital diagnosed with CAP and HAP from 2010.02 to 2013.02 were collected. The informations, including age, sex, clinical diagnosis, hospitalized departments, onset of disease, the used antimicrobial agents and etiological data were recorded. CAP and HAP were determinated based on the Guide for diagnosis and treatment of CAP and HAP(both published by CSRD), respectively. The sputum from the patients were collected, which excluded those of patients infected by atypical pathogens and fungus. The sputums were prepared in sterile containers for most patients after rinse the oral cavity by saline, while those of the remaining patients were collected by the aseptic suction catheter. The specimens were inspected and qualified after collection immediately. The common antibiotics(19 kinds) were used. The susceptibility testing was carried out by Kirby-Bauerdisk diffusion. The strains of pathogenic bacteria and drug-resistant were according to the American association of clinical and laboratory standards(2010 version).Results: 1. In this study, 374 cases of CAP(male: 243 cases; female 131 cases; average age: 48.8±11.9) and 519 cases of HAP(male: 324 cases; female 195 cases; average age: 48.2±12.4) were included. There was no statistically significant difference in sex and age between two groups. 2. The analytical results of basic diseases suggested that the percentages of cardiovascular disease, COPD, diabetes and severe hepatic and renal dysfunction inCAP patients were 29.94%, 24.86%, 13.90% and 14.97%, respectively, while those of HAP were 28.32%, 24.86%, 19.65%. 3. G- bacteria were the main pathogens in CAP and HAP patients, which including Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa. The strains of Klebsiella pneumoniae and Escherichia coli accounted for 43.7% and 11.2% of total strains in CAP group, while the proportions of Pseudomonas aeruginosa and Klebsiella pneumoniae in HAP group were 31.7% and 14.8% respectively. Drugresistances to the commonly used antibiotics were observed in the main G+ and Gpathogens. The G+ pathogenic bacteria were sensitive to vancomycin and moxifloxacin with the resistances below 20%, while those of G- bacteria were susceptive to amikacin, imipenem, moxifloxacin and cefpirome.Conclusion: 1 The results of diseases analysis indicated that COPD had a prevalence in patients with cardiovascular disease. 2 G- bacteria were the main pathogens in CAP and HAP patients, which including Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa. Earlier analysis of pathogens and its drug-resistance can improve efficacy of antibacterial to the CAP and HAP. 3 Drug- resistances to the commonly used antibiotics were observed in the main G+ and G- pathogens. The G+ pathogenic bacteria were sensitive to vancomycin and moxifloxacin with the resistances below 20%, while those of G- bacteria were susceptive to amikacin, imipenem, moxifloxacin and cefpirome. 4. Earlier analysis of pathogens and detection of drug-resistance could increase the therapeutic effects of antibiotics on CAP and HAP, which provided experimental basis for clinic medication in our hospital.