Analysis Of The Pathogens Distribution And Antimicrobial Resistance In Lower Respiratory Tract Infetion

Objective:To provide references for clinical initial anti-infection therapy, we analyzed the pathogenic bacteria distribution and drug sensitivity of hospitalized patients in lower respiratory tract infection.Methods:To do isolated culture and drug sensitive experiment of specimens from 3155 cases of lower respiratory tract infection in Respiratory Department of the First Affiliated Hospital of Chongqing Medical University in 2013, and compare dynamically with the test results of 2011 and 2012.Results:The top three of lower respiratory tract infection in the recent three years are Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae. Staphylococcus aureus increase, Stenotrophomonas maltophilia, Streptococcus pneumoniae plays a small part. A.baumannii is serious multiple drug resistant, which is more than 70% susceptible to minocyline, the sensitivity to other common antibiotics is less than 40%, and declines year by year in non-ICU, but changes little in ICU. Paeruginosa is more than 70% sensitive to piperacillin-tazobactam, ceftazidime, cefepime levofloxacin, meropenem, imipenem, amikacin in non-ICU for the three years,50%-70% in ICU. Both strains which is resistant to carbapenem increase year by year. Stenotrophomonas maltophilia is sensitive to minocycline, levofloxacin. Staphylococcus aureus is always 100% sensitive to vancomycin, linezolid, tigecycline, but MRSA increaces. Klebsiella pneumoniae and E. Coli are always more than 80% sensitive to carbapenems, piperacillin-tazobactam, cefotetan.Increasd ESBLs-producing Klebsiella pneumoniae which is resistant to carbapenem are alarming. Haemophilus influenzae is 85% sensitive to carbapenems, ceftazidime, cefuroxime, ciprofloxacin, levofloxacin, amoxicillin and clavulanate potassium. Streptococcus pneumoniae is always 100% sensitive to vancomycin,80%-96% sensitive to levofloxacin, penicillin.Conclusion:Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae have became the main pathogens in the respiratory tract infection. A. baumanniiserious is serious multiple drug resistant and shortage of available antibiotics in the clinic. Moreover, the increase of ESBL positive Klebsiella pneumoniae which is resistant to carbapenem and MRSA bring clinical treatment with much more difficult than ever. It is possible to control and to relieve bacteria resistance by choosing antibiotics based upon the results of isolated culture and drug sensitive experiment.