| ObjectiveTo analyse in The Jinan Third People’s Hospital patient specimens of all kinds of detection,distribution and drug resistance of E.coli,K.pneumoniae P.aeruginosa,reasonable choice of antibiotics provide scientific guidance for clinical treatment and experimental basis,reduce the resistant bacteria produce,effective control of clinical infection,at the same time reduce the occurrence of hospital infection.MethodsTo collect all of Jinan city from 2013 to 2016 in The Third People’s Hospital inpatient department of sputum,urine,blood,exudate,drainage of liquid,pus,secretion,pharyngeal swab specimens a total of 13714 copies,according to the national clinical laboratory operation rules for vaccination,the preliminary separation of bacteria,and then use VITEK2-COMPACT automatic microbe instrument and identification cards for the separation of bacteria species identification,analysis of drug susceptibility test at the same time,the drug sensitive test result determination standard according to The Clinical and Laboratory Standards Institute(CLSI)in 2009 the judgment standard,namely on the basis of each drug minimum bacteriostatic concentration(MIC)values to determine the sensitivity of the strain.All data were processed with SAS9.1 software package.Results1.Source and distribution of specimens(1)Specimen type:The specimens included 4614 sputum,5250 urine,477 blood,1114 exudates,636 drainage of liquid,891 pus,477 secretions,and 255 pharyngeal swab.(2)Time distribution:The time distribution was 2,947 copies from January to March;From April to June was 3,208 copies;From July to September was 3,871copies;and 3,688 copies from October to December.2.Pathogen examination(1)Pathogen detection:3880 strains of pathogenic bacteria were detected in 13,714 specimens.The Gram-negative bacteria were the main ones,a total of 2772 strains,accounting for 71.4%(2772/3880),the top three was E.coli(899 strains),K.pneumoniae(461 strains)and P.aeruginosa(411 strains).The 770 strains of Gram-positive bacteria accounted for 19.8%(770/3380),mainly Staphylococcus aureus(248 strains).Fungi 338 strains,accounting for 8.7%(338/3880),were mainly White candida yeast.There was no difference in the composition of the three types of pathogenic bacteria(P>0.05).(2)Main pathogenic bacteria:The main pathogenic bacteria composition ratio.The largest part of the group was E.coli,followed by K.pneumoniae and P.aeruginosa,and the smallest was A.baumannii.3.Detection rate and epidemiological characteristics of the three types of pathogenic bacteria(1)E.coli:The detection rate of E.coli was 6.6%(899/13714),mainly in patients with Respiratory Medicine,accounted for 16.2%,with sputum,urine specimens detected most,42.2%and 31.6%respectively;Statistical analysis showed that there was no statistical difference in the time distribution of E.coli(P>0.05),from July to September samples detected was more,nearly four years detection rate was respectively:2013 7.1%,2014 6.0%,2015 8.2%,2016 5.4%,the detection rate was on the decline as a whole.(2)K.pneumoniae:The detection rate of K.pneumoniae was 3.4%(461/13714),in the Department of Critical Care Medicine detection rate was higher,accounting for 18.0%,mainly existed in sputum and urine,54.7%and 26.9%respectively.Statistical analysis showed that there was a statistical difference in the time distribution of K.pneumoniae(P<0.05),From July to September check out more,and the overall decline rate in nearly four years,were 2013 4.4%,2014 3.1%,2015 3.9%,2016 2.4%.(3)P.aeruginosa:The detection rate of P.aeruginosa was 3.0%(411/13714),which was mainly distributed in the Department of Critical Care Medicine accounting for 28%;The highest detection rate in sputum samples was 37%.Statistical analysis showed that there was a statistical difference in the time distribution of P.aeruginosa(P<0.05),The number of detected months was from July to September.Nearly four years detection rate was respectively:2013 4.1%,2014 3.1%,2015 2.8%,2016 2.2%.4.Analysis of drug resistance of E.coli,K.pneumoniae and P.aeruginosa.(1)E.coli and K.pneumonia:The resistance of E.coli and K.pneumonia was low,among them Imipenem,Meropenem,the third generations of cephalosporins Cefotetan and Piperacillin/tazobartan and aminoglycoside resistance of Amikacin was<5%,K.pneumoniae of Meropenem resistant rate of 0,E.coli and K.pneumonia bacteria to the second generation cephalosporins Cefuroxime sodium resistant rate of 100%and 85%respectively.(2)P.aeruginosa:The drug resistance rate of P.aeruginosa was close to 100%in Ampicillin and Ampicillin/sulbatan.The drug resistance rate of aminoglycoside drugs such as Amikacin was 9%;The drug resistance rate of quinolone Ciprofloxacin and Levofloxacin was 27%,and the drug resistance rate of Meropenem,Imipenem was 20%and 23%respectively.ConclusionThe Third People’s Hospital of Jinan city from 2013 to 2016 hospitalized patients in the three main Gram-negative bacterium E.coli,K.pneumoniae and P.aeruginosa detection rate was higher,and the declining trend year by year,E.coli were mainly distributed in the Department of Respiratory,most detection in sputum and urine specimens,K.pneumoniae and P.aeruginosa were mainly distributed in the Department of Critical Care Medicine,most detected in the sputum.The three kinds of bacteria resistance was relatively stable,in the clinical drug use guided by the drug sensitive test,application,relatively low percentages of drugs,bacterial drug resistance monitoring should be strengthened at the same time,the reasonable use of antibiotics in order to reduce the generation of drug-resistant strains,should avoid multiple drug-resistant strains produced,to effectively control the occurrence of hospital infection. |
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