Retrospective Investigation Of 430 Emergency ICU Pathogenic Bacteria Distribution And Drug Resistance Strains

objective:To investigate the pathogen distribution and drug resistance of bacterium during the emergency intensive care unit(EICU) in the first affiliated hospital of Nanchang university. To investigate the co mmunity acquired and nosocomial acquired engraftment multi-resistant bacterium infection during in EICU. Providing bacteriological basis for guiding clinical rational drug use and the control of nosocomial infection.Methods:1. Retrospective analysis was made for the samples training, isolation, identification and drug susceptibility test results collected from cases of hospitalized patients admitted in EICU in our hospital during the period from November 2013 to March 2015. Analysis common pathogenic bacte rium distribution and drug resistance in clinical, Excell and SPSS 13.0 software is used for statistical analysis.2. Adopting forward- looking design, collecting nasal vestibular secretions, bacterium culture and isolation from new cases of patients at the time of admitting EICU, 48 hours after admitted EICU, 7 days and discharged EICU during the period from October 2014 to February 2015.Bacterium culture and separate identification were made and Excell is used for statistical analysis.Results:1.In November 2013 to March 2015, 690 patients were treated in the first affiliated hospital of nanchang university emergency ICU and 1052 cases of clinical samples. were collected.2.The highest pathogen mainly comes from the respiratory tract, 321 strains, followed by 36 strains of blood and urine,28 strains, wound secretion,24 strains, others such as ascites, pleural effusion, stool, cerebrospi nal fluid, catheter tip accounted for 4.88%.3.Clinical samples were detected and 430 strains of pathogenic bacterium were isolated, of which 355 strains of bacterium and 75 strains of fungus,separation of pathogenic bacteria positive rate was 40.87%. Including the gram- negative bacteria(G-) 306 strains, accounting for 86.2%, the gram-positive cocci(G+) 49 strains, accounting for 13.8%. The top five o f the separation rate from high to low were: 103 strains of acinetobacter baumannii, 52 strains of candida albicans,34 strains of pseudomonas aeruginosa, 32 strains of e. coli, 29 strains of klebsiella pneumonia.there are 13 strains of e. coli producing ESBLs, 11 strains of klebsiella pneumoniae producing ESBLs, e. coli and klebsiella pneumonia bacteria producing ESBLs positive rate were 40.62% and 37.93% respectively. 49 strains gram-positive bacteria, including: staphylococcus aureus most, followed by epidermis staphylococcus aureus, staphylococcus subspecies, hemolytic staphylococcus, streptococcus viridans.Strains from dung enterococcus excrement intestines ball.Most fungi, a total of 75 strains, candida albicans, followed by tropical candida, smooth candida, aspergillus, grams of candida.4. analysis of drug resistance: drug resistance of Gram- negative bacterium was very serious. most of multiple drug resistance and extensive drug resistance.The detection rate of methicillin-resistant staphylococcus aureus was 64.68%, staphylococcus aureus resisted to vancomycin, teicoplanin, linezolid were didn’t found.Dung enterococcus and excrement enterococcus resisted to vancomycin, teicoplanin, linezolid were didn’t find. candida albicans had high sensitivity to all sorts of antifungal drugs, 90% of which were sensitive to fluconazole, voriconazole, 5- fluorine cytosine, amphotericin–B.5.The results of the pharyngeal swab: 59 cases with nasal vestibular throat swab specimens of common bacterium were isolated of the 120 patients, and even multiple drug-resistant bacteria, accounting for 49.2% of the patients(59/120), such as the epidermis staphylococcus up to 25 strains(including MRS accounted for 60%), followed by klebsiella pneumoniae, enteroaerogen. Throat swab specimens after 48 hours admitted into EIC U cultured 150 strains of common pathogenic bacterium, such as staphylococcus aureus, e. coli bacterium, acinetobacter baumannii, pseudomonas aeruginosa, fungus, etc. 0bvious engraftment of high rate of patho genic bacteria were didn’t see. Throat swab specimens after 48 hours admitted into EICU cultured 150 strains of common pathogenic bacterium, such as staphylococcus aureus, e. coli bacterium, acinetobacter baumannii, pseudomonas aeruginosa, fungus, etc. Obvious engraftment of high rate of pathogenic bacterium were didn’t see.Conclusion:1. The specimens of the separation of pathogenic bacteria of source mainly respiratory tract and blood and the urinary tract.The pathogenic bacterium separated in EICU in our hospital were mainly gram- negative bacterium, mainly including acinetobacter baumannii, candida albicans, pseudomonas aeruginosa, e. coli, klebsiella pneumonia, was highly resistant to commonly used antimicrobial agents and multiple drug resistance, fungal infection should not be ignored. The EICU in our hospital had kinds of pathoge nic bacteria species, more grim situation of clinical antiinfection should be treated, therefore, clinical doctors should be on the basis of the reasonable choice of antimicrobial agents susceptibility monitoring in order to improve the cure rate.2. The ratio of the patients admitted into our EICU with community acquired MRS was high, indicating CA-MRS patients would also gradually increase. Engraftment multi-resistant bacteria and infection rate was high in our EICU, measures should be strengthen appropriately on nosocomial infection control and etiology and drug resistance surveillance to reduce hospital cross infection.