| Backgroud The proportion of bacterial pneumonia accounted for 80% of pneumonia in adults of various kinds of pathogens, and which was one of the most common types of pneumonia and one of the most common infectious diseases. Bacterial pneumonia pathogens mainly included Streptococcus pneumoniae, Escherichia coli, Staphylococcus aureus, Alpha hemolytic streptococcus, Klebsiella pneumoniae, Bauman Acinetobacter, Pseudomonas aeruginosa and so on. Before the application of antimicrobial, fatality rate of bacterial pneumonia in children, the elderly and immunosuppressive patients is extremely high. With the wide application of antibacterial drugs, pneumonia mortality was obviously decreased. However, in recent years, despite the use of strong antimicrobial application and effective vaccine, the total overall mortality of Pneumonia did not reduce, even up to a certain extent. The emergence of this phenomenon is mainly due to widely use of the clinical broad-spectrum antibiotics, introducing of a large number of new drugs, which significantly changes species composition and its sensitivity to antibiotics which led to the increased resistance to bacteria. Therefore, it is very important to improve the etiology diagnosis and rational use of antibiotics, avoid the generation of drug-resistant bacteria, enhance the clinical treatment of pneumonia, prevent and control of hospital infection that monitoring the source of the bacterial pneumonia pathogen and engraftment of bacterial resistance.Objective It provided a reliable basis for clinical reasonable select and use of antibiotics to treat bacterial pneumonia that to survey the source of the infection of pathogenic bacteria distribution and drug sensitivity and bacterial drug resistance of patients with bacterial pneumonia of Xinxiang central hospital from July 2012 to June 2014, and to analyze the relationship between the source of resistant bacteria of bacterial pneumonia, nosocomial infection and dug-resistant strains after antibiotic use.Method1. Samples (sputum, blood, urine, Cerebrospinal fluid, Puncture fluid and secretions) and Clinical and epidemiological data of Bacterial pneumonia patients were collected from the Central Hospital of Xinxiang between July 2012 and June 2014.2. VITEK automatic microbial analysis instrument was used to separate and identify the bacteria of the samples (sputum, blood, urine, Cerebrospinal fluid, Puncture fluid and secretions).3. Kirby Bauer disc diffusion method was used to evaluate the bacteria antimicrobial drug susceptibility activity of more than 20 common drugs. Analyze its resistant characteristics.4. Rep-PCR was used to identify the bacteria.5. Statistical methods:SPSS 17.00 software was used to analyze the data.Results 567 cases of bacterial pneumonia patients were collected during July 2012 to June 2014, Female 189 and male 378. Clinical specimens mainly from sputum (794), blood(45), urin(40) and secretions(24). A total of 903 strains pathogenic bacteria were detected, among them 285 strains were Acinetobacter baumannii (31.6%),229 strains were Klebsiella pneumonia (25.3%),222 strains were Pseudomonas aeruginosa (24.6%),129 strains were E. coli (14.3%) and 38 strains were Staphylococcus aureus (4.2%). Susceptibility results:Klebsiella pneumoniae (ESBL+) strains were highly resistant to cefotaxime, cefazolin, Ampicillin-Sulbactam, piperacillin with the drug resistance rate of 97.76%、96.63%、96.63% and 95.51%; but sensitive to meropenem, imipenem and cefoperazone/Sulbactam. E. coli (ESBL+) strains were highly resistant to cefotaxime and cefazolin with the drug resistance rate of 98.88% and 95.51%, but sensitive to meropenem, imipenem, cefoperazone/Sulbactam and polymyxin. Acinetobacter baumannii strains were highly resistant to amoxicillin/clavulanic acid, ampicillin, cefazolin,Piperacillin, chloram- phenicol, Aztreonam with the drug resistance rate of 100%,100%,99.65%、97.19%、 96.8% and 95.43%, but sensitive to polymyxin. Staphylococcus aureus strains were highly resistant to ampicillin and penicillin with the drug resistance rate of 100%, but sensitive to Teicoplanin and vancomycin. Pseudomonas aeruginosa strains were highly resistant to ampicillin, amoxicillin/clavulanic acid, paediatric compound sulfamethoxazole tablets, and cefotaxime with the drug resistance rate of 100%,99.1%、98.65% and 98.65%. There were five different belt types of 14 strains Klebsiella pneumonia bacteria. Among them,6 strains of type A,3 strains belong to B type,2 strains belong to C type,2 strains belong to D type and 01 strain belongs to E type.Conclusion Acinetobacter baumannii, Klebsiella pneumonia and Pseudomonas aeruginosa are the mainly bacteria which causing bacterial pneumonia of Xinxiang area. Bacterial resistance to antibiotics is common and there exist nosocomial infection of Klebsiella Pneumoniae in our hospital. We should pay more attention to the resistance to various antibiotics in bacterium. And the resistance surveillance is of great importance for clinically rational usage of antimicrobials. |
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