Resistance Of Gram-negative Bacillus To Carbon Green Enzyme Olefine And Aminoglycoside

Objective: Bacterial resistance has been issues of concern at home and abroad in recent years, with the non-standard use of antibiotics, Gram-negative(G-) bacilli become a major pathogen of nosocomial infection. Gram-negative bacteria rapidly developing resistance has become a major clinical problem of anti-infective therapy, especially the emergence of multi-drug resistant strains, it becomes increasingly difficult to treat. Carbapenem antibiotics as effective broad-spectrum β- lactam antibiotics,which has antibacterial activity,and the minimum inhibitory concentration(MIC) is very close to the minimum bactericidal concentration(MBC),was commonly used in multi-drug resistant Gram-negative bacilli infections. The Carbapenems is stability for most β-lactamase, and without cross-resistance to third-generation cephalosporins. Aminoglycoside antibiotics as a stationary phase of sterilization drug for the treatment of gram-negative bacterium coli infection has 50 years of history, which PAE is longer against Pseudomonas aeruginosa, Escherichia coli and other gram-negative bacilli often used in the treatment of aerobic gram-negative bacilli. Studies have found that inhalation therapy in the treatment of refractory/resistant ventilator-associated pneumonia, and its high-dose short-term therapy(with β-lactam antibiotics in combination) has potential advantages in the treatment of shock or hypotension psychosis serious infections, so there is still used in the treatment of serious infections caused by Gram-negative bacilli. However, with the overuse of antibiotics clinically, resistant rate of the gram-negative increased year by year. Therefore, mastering the drug resistance of gram negative bacilli and the dynamic change trend is of great significance to delay the production of bacterial drug resistance, which also can guide the clinical experience administration and prevent nosocomial infection.Methods: All kinds of specimens collected in Yijishan Hospital from January 2010 to December 2013, accepted by the bacteria room wards from outpatients and inpatients. Cultivation and isolation was operated with the methods descripted by the National Clinical Laboratory Operational Regulation. The resistant rate of bacteria according to the guidelines of CLSI 2012, all dates were analyzed with SPSS 19.0 software and WHONET5.0 software and mapping using Microsoft Excel software. The methods against Gram-negative bacteria clinical distribution, changes in carbapenem and aminoglycoside antibiotic resistance and sensitivity rates analyzed by epidemiological methods retrospectively. This study collected the common Gram-negative bacilli Yijishan Hospital from 2010 to 2013, to retrospectively analyzed their changes in carbapenem and aminoglycoside antibiotic resistance, provide the basis for the clinical experience administration.Results: 1.11,172 gram-negative bacilli strains isolated from 20623 strains from January 2010 to December 2013,accounting for 54.17%, has been increased year by year. Therefore gram-negative bacillus become the main bacteria of nosocomial infection. There is higher for the detection rate of Pseudomonas aeruginosa up to 2489 strains(accounting for 12.07%).2.Drug resistance analysis:The drug tolerance rate of most gram-negative bacillu to carbon penicillium alkene and aminoglycoside is rising,and Non-fermenting bacteria resistant relatively more serious situation than Enterobacteriaceae. The Aminoglycoside resistance of Gram-negative bacilli was more quite stability than that of the Carbapenem antibiotic. the resistance rate of Acinetobacter on aminoglycosides and carbapenems all greater than 55%.The case detection rate of Stenotrophomonas matophilia and Burkholderia cepacia has been increased year by year. Control and therapy of Stenotrophomonas matophilia and Burkholderia cepacia in clinic become more and more difficult, because it has special mechanisms of natural resistance on carbapenems and aminoglycosides, and the resistance rates as high as 100%.Conclusion: With the irrational use of antibiotics in clinical, Gram-negative bacteria is becoming a common nosocomial infection pathogens and the drug resistance is do more serious, resistance mechanisms are also increasingly complex. To do this we need to strengthen the management of antibiotics, strictly in accordance with the appropriate choice of antibiotic susceptibility testing, to minimize the generation of resistant bacteria.