Analysis Of Detection Rate And Drug Resistance Of Pathogenic Bacteria In A Hospital Of Qiqihar In 2012-2014

Objective : Infectious disease is a serious hazard to human health, the information shows that nearly 17 million people worldwide each year die from infectious diseases, accounting for about 28 to 33% of the total deaths, showing high mortality. In the hospital, especially those with underlying immunocompromised populations(such as cancer, blood disease, low or no agammaglobulinemia, AIDS) or long-term hospitalization of patients(large number of antibiotics, etc.) in the process of contacting pathogenic microorganisms difficult to resist, resulting in patient infection. Moreover, the infection caused by pathogens are often multi-drug resistant bacteria. A survey shows that patients with multi-drug-resistant infections have occupied most of the total number of hospital infections, and hospital infection rate was significantly larger than small hospitals. Moreover, multi-drug resistant(MDR), pan-resistant(XDR), and full resistance(PDR) bacteria appear to limit treatment options against infection, infection increases mortality. This study of Qiqihar of a hospital 2012-2014 years of clinical inspection of the 17,959 parts microorganism samples were analyzed retrospectively to investigate the source of the distribution of pathogens in 5343, the department distribution, distribution and types of pathogens for antibiotic resistance, analysis of patient population risk factors, clinicians, nurses treat and care for people suffering from infectious diseases to provide reference.Methods: Collection of a hospital in Qiqihar City, 2012--2014 years, intensive care unit, neonatology, pediatrics, internal medicine kidney, respiratory, emergency department, one or two subjects, bone surgery, neurosurgery submission microbial specimens total 17,959 samples. Mainly from sputum specimens, wound secretions, urine, throat, blood, feces, catheter, puncture fluid and drainage(including cerebrospinal fluid, pus, ascites, pleural effusion, bile), except to repeat the same patient strains isolated. According to the "National Clinical Laboratory Procedures" were cultured and identified by bio Merieux Vitek-2 microbial identification system, using the agar diffusion method(K-B) and MIC method for routine susceptibility testing. Pathogenic type, sample distribution, and distribution departments pathogens to commonly used antibiotics rate case by SPSS19.0 statistical software and Who net5.6 software for statistical analysis.Results: 1.during the period of 2012-2014, the 5343 positive samples in gram negative bacteria detection rate was 69%, gram positive bacteria detection rate was 19.8%, the detection rate of fungi was 11.2%. The detection rate of gram negative bacteria was 72.1%, 69%, 3, respectively. The positive rate of gram positive bacteria was 21.1%, 20%, 19%, respectively. The detection rate of fungi was 6.8%, 11% and 13.6%, respectively. 2. High detection rate of pathogenic bacteria and gram negative bacteria were Klebsiella pneumoniae and 15% Escherichia coli, 12.7%, 7.4% of Acinetobacter, Pseudomonas aeruginosa 6.1%. The high detection rate of pathogenic bacteria in gram positive bacteria were Staphylococcus aureus 5.3% and Staphylococcus aureus 3.8%. The higher detection rate of fungi was Candida albicans 9%. 3. From the perspective of the sample type distribution of pathogenic bacteria: Klebsiella pneumoniae detection rate in sputum samples in 20.4%; Escherichia coli in urine was 43.9%; the highest positive rate of Staphylococcus aureus in wound swab in the highest detection rate was 12.4%. From the view of the distribution of pathogenic bacteria of the Department: Klebsiella pneumoniae, Acinetobacter, Escherichia coli, Pseudomonas aeruginosa and other opportunistic pathogens in respiratory medicine, ICU, Department of cerebral surgery, emergency department of Neonatology, higher detection rate, >10%, the Department in patients with low immunity, high infection condition chance of pathogenic bacteria. 4. From the drug resistance of pathogens to see: Klebsiella pneumoniae to cephalosporins resistance rates are> 30%; to piperacillin / tazobactam resistance is low, <30%; the whole sensitive to meropenem. Escherichia coli to cephalosporins, aztreonam, and quinolone antibiotics resistance rate,> 30%; to ampicillin / sulbactam, piperacillin / tazobactam resistance is low, <30%; in 2012 and 2014, meropenem-resistant strains have appeared. In addition, the resistance rate of Pseudomonas aeruginosa to piperacillin, piperacillin / tazobactam high,> 30%; low resistance rates to colistin, <5%; Acinetobacter gentamicin, amikacin, colistin low resistance rate <30%, in which the lowest rate of colistin resistance, <3%. Staphylococcus aureus to penicillin, erythromycin, clindamycin resistance rate of> 30% for moxifloxacin, chloramphenicol resistance is low, <30%, all sensitive to vancomycin. Enterococci to penicillin, erythromycin, fluoroquinolones resistance were high,> 50%, a high concentration of vancomycin and gentamicin rate, <10%. 5. 2012--2014 years, includes a variety of mechanisms of resistance resistant high detection rate were 13.7%, 14.6%, 12.1%. The most common drug types are: producing extended spectrum ?- lactamases bacteria, methicillin-resistant Staphylococcus aureus, multidrug-resistant Pseudomonas aeruginosa and multidrug-resistant Acinetobacter baumannii.Conclusions: 1. The main pathogens causing nosocomial infections were Gram-negative bacteria, followed by Gram positive bacteria. 2, leading to the infection of pathogenic bacteria for the conditions of pathogenic bacteria. 3, different pathogenic bacteria sample distribution law is different. 4, from the distribution of the pathogenic bacteria in the Department of respiratory medicine, intensive care unit, Department of cerebral surgery, emergency department and neonatal department of pediatric patients with immune function. 5, the drug resistance of bacteria is serious.