The Patients In Hospital-Acquired Gram-Negative Bacilli Pneumonia:Their Drug Resistance Feature

Objective:To investigate the drug resistance characteristic of Pathogenic bacteria in hospital-acquired Gram-negative bacilli pneumonia, and help clinical preventative and therapeutical work.Method:115 cases of hospital-acquired pneumonia caused by Gram-negative bacteria were collected in First Affililiated Hospital of Guangxi Medical University from March 2014 to March 2015, the bacteria samples from sputum, blood, bronchoalveolar lavage fluid and puncture fluid, its clinical information and drug sensitive test results were analyzed retrospectively.Results:349 Gram-negative bacteria strains were separated from 115 patients, The detection rate of the top four were Acinetobacter baumannii(Ab), Pseudomonas aeruginosa(Pa), Klebsiella pneumonia(Kp) and Escherichia coli(E.coli), accounting for 46.4%,26.9%,12.3% and 6.3% respectively. The Multidrug resistant bacteria(MDRO) detection rate was 59.8% in mainly Gram-negative bacilli, of which Ab was 64.8%, Pa 56.4%, Kp 48.8%, E.coli 59.1%. Single factor chi-square test result:Hospital stays surpass thirty days, application of respirator, time of antibiotics application surpass thirty days, major operation or trauma, reducing of T cell subsets patients have higher MDRO detection rate. Resistance rate:the Ab resistance rate of Cefoperazone/sulbactam was 43.2%, the rest of the antibiotic resistance rates exceeded 50.0%; The Pa resistance rates of ampicillin, ceftriaxone, cefoxitin were 100.0%,and resistance rate of tigecycline was 71.3%,and resistance rate of Polymyxin-B was only 8.5%, resistance rate of Imipenem was 85.1%. The E.coli and Kp resistance rates were similar, the resistance rates of Amikacin, tigecycline, cefoperazone sulbactam, piperacillin tazobactam were less than 10%, and both sensitive to imipenem.Conclusions:The most Gram-negative bacilli which separated from hospital acquired pneumonia in our hospital are Acinetobacter baumannii and Pseudomonas aeruginosa, and there resistance rates of Carbapenem is high, may be related to high usage rate Carbapenem in some departments of our hospital, clinical doctors should caution about drug selection.