Distribution And Antibiotic Resistance Of Common Pathogens Causing Noscomial Imfection In Rongcheng People's Hospital During 2014

Objective A retrospective analysis was carried out to analyze the distribution and antibiotic resistance of clinical isolates in Rongcheng People's Hospital from Jan 1st 2014 to Dec 31th2014,so as to provide reference for the clinical use of antibiotics and reduce the ocurrence of bacterial drug resistance.Methods 10122 clinical samples were collected in Rongcheng People's Hospital from Jan 1st 2014 to Dec 31 th 2014,including sputum,whole blood,urine,secretions,swabs,pus,bile,cerebrospinal fluid and water drainage fluid.The pathogenic bacteria were identified and the antimicrobial susceptibility was assessed by VITEK-2 compact automated microbiology system,according to the American association of clinical and laboratory standards CLSI 2013 edition of the salient point.The data was analyzed by WHONET 5.6 Software.Results Among 10122 clinical samples,the repeated strains of the same patients of the same parts within 7 days were removed,1711 strains of bacteria were isolated,the positive rate was 16.90%,which came mainly from the clinical departments of nerve surgery 12.2%,surgical ICU 11.4%,medicine ICU general 8.4%,liver and gallbladder surgery 6.4% and respiratory medicine 5.4%.Positive specimens isolated mainly from sputum,urine and the whole blood,including 76.5%(1309/1711)Gram negative bacteria and 14.3%(245/1711)Gram positive bacteria,and the most common pathogenic bacteria were Escherichia coli28.6%(489/1711),Klebsiella pneumoniae13.7%(234/1711),Pseudomonas aeruginosa 14.7%(252/1711),Staphylococcus aureus 8.5%(145/1711)and Acinetobacter baumannii 7.5%(128/1711).The majority of Gram-negative isolates included two major categories of Enterobacteriaceae and non-fermentative bacteria,showed higher resistance to penicillin,cephalosporin,monocyclic antibiotics aztreonam,but lower resistance to the combination of?-lactam / enzyme inhibitor(piperacillin / tazobactam),carbapenem antibiotics(imipenem)and aminoglycoside antibiotics amikacin.The Acinetobacter baumannii showed high sensitivity to imipenem,amikacin,piperacillin/ tazobactam,but resistance to other antibiotics.Pseudomonas aeruginosa maintained high sensitivity to most of the antibiotics.The isolates of Staphylococcus aureus and Enterococcus faecium were resistant to penicillin,clindamycin,ciprofloxacin and erythromycin(50%),but no strains resistant to vancomycin and linezolid.The positive rate of multi-drug resistant strains were 10.3%,including ESBLs-producing Escherichia.coli(141strains),Klebsiella pneumonia(24 strains),Benzene azole Westwood resistant staphylococcus aureus(11 strains)and multi-resistant/generic drug resistant Pseudomonas aeruginosa(1 strains),most of the multi-drug resistant strains showed higher resistance to aztreonam,levofloxacin,ceftriaxone,lower resistance to imipenem,amikacin and piperacillin /tazobactam.Conclusions Most of the isolates in our hospital were Gram-negative bacteria,which was dominated by Escherichia.coli,Pseudomonas aeruginosa and Klebsiella pneumoniaand,the majority of the isolates were resistant to most antibiotics.The hospital should enhance microbiological test to promote clinical rational use of antimicrobial agents and reduce the incidence and spread of multi-drug resistant strains.