| Objective: To analyze the distribution and drug resistance of the pathogens causing lower respiratory trace infections in respiratory department of Guizhou Provincial People’s Hospital and provide guidance and evidence for clinical medication.Methods:The clinical data of 472 with lower respiratory tract infections were retrospectively analyzed in Guizhou Provincial People’s hospital from October 2013 to October 2014.Results: A total of 472 strains of pathogens were isolated,among which 404 strains of gram-negative bacteria accounted for 85.6%, 31 strains of Gram-positive bacteria accounted for 6.6%, and 37 strains of fungi accounted for 7.9%. The most predominant pathogens isolated were Klebsiella pneumoniae with the detection rate of21.0%, followed by Pseudomonas aeruginosa(16.1%), acinetobacter(12.1%),Escherichia coli(8.9%) and Stenotrophomonas maltophilia(5.9%). The most common gram-positive bacteria isolate were streptococcus pneumoniae(3.0%) and Staphylococcus aureus(2.8%). The main fungus was Candida albicans(6.6%). The resistance rates of Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter to Ceftriaxone Sodium, cefoperazone/sulbactam, imipenem, meropenem were relatively low(<10.5%); The resistance rates to piperacillin/tazobactam, ampicillin/Shubatan,aztreonam, ceftazidime, and fluroquinolones were relatively lower(<20%), but they had a higher resistance to ampicillin and piperacillin. The resistance of Escherichia coli to ampicillin/Shubatan, aztreonam and fluroquinolones was revelatively high( >30%)but they remained sensitive to carbapenems. The resistance of staphylococcus aureus to penicillin, erythromycin, clindamycin and ciprofloxacin was high and the resistance of staphylococcus aureus to rina thiazole amine and voriconazole was 7.7%. Theresistance of Streptococcus pneumoniae to erythromycin, clindamycin was high.Streptococcus pneumoniae was sensitive to levofloxacin, ciprofloxacin, penicillin, and the resistance to linezolidand and vancomycin were 0. Fungal resistance rate was generally low. The resistance rates to fluconazole, itraconazole, voriconazole, and fluorine cytosine were 9.7%,16.1%, 6.5%, and 9.7% respectively. The resistance rate to Amphotericin B was 0.Conclusion: Gram-negative bacilli was the most common pathogens causing lower respiratory tract infections, the gram-negative bacilli with high detection rate had different levels of drug resistance to commonly used antimicrobial agents. The main gram-positive cocci had a widespread resistance to erythromycin and clindamycin,and fungi had a lower resistance. In order to avoid the resistance caused by antibiotic selective pressure, the clinical physician should pay more attention to the examination,drug resistance monitoring and rational use of antimicrobial drug.Objective:To evaluate the value of PCT in differentiating different types of pathogen infection through observation of its level in patients with severe pulmonary infection in RICU.Methods : 102 patients with severe pneumonia were divided into gram-positive bacteria(G+), gram-negative bacteria(G-), fungi(F), G+ + fungus group(G ++ F), G-+ fungus group(G- + F). Serum PCT level and C- reactive protein(CRP) level were detected.Results:1. In patients with single infection, PCT level was highest in gram-negative bacilli group,second highest in gram-positive cocci group while fungal infection group was lowest.For compound infection, PCT level in gram-negative + fungus group was higher than in the gram-positive + fungus. PCT level for compound infection was higher than that for single infection(P<0.05). There was no difference in serum CRP among different groups(P > 0.05).Conclusion: PCT level in severe pulmonary infection caused by different pathogenic bacteria was different, so it had a certain differential diagnosis value. The increase of PCT may suggest the gram-negative bacilli infection or the compound infection. At the same time, high CRP and low PCT may suggest fungal infection. |
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