Distribution And Antimicrobial Resistance Profile Of Common Pathogens Isolated From Lower Respiratory Secretion In Affiliated Hospital Of Yanbian University,2014-2016

Objective:To analyze the distribution characteristics and drug resistance of isolates detected in the lower respiratory tract specimens of the affiliated hospital of Yanbian University from 2014 to 2016.Methods:We used the paper diffusion method(K-B method)and MIC method for the separation of clinical isolates of lowerrespiratory tract bacteria from the hospital ofYanbian Uni vrsity from 2014 to 2016.According to the US version of CLSI 2015 interpretation of drug sensitivity,WHONET 5.6 software was used for data analysis.Results:From 2014 to 2016,2305 strains of bacteria were isolated from the lower respiratory tract of our hospital.1977 Gram-negative bacteria(85.8%)and 328 Gram-positive bacteria(14.2%)were isolatecd Specimens contained 96%sputum,and pleural effusion and bronchoalveolar lavage fluid accounted for 4%.The six isolates with the highest 3-year detection rates were Acinetobacter baumannii,Klebsiella pneLumoniae,Pseudomonas aeruginosa,Escherichia coli,Enterobacter cloacae,and Staphylococcus aureus.The five isolates with the highest detection rate of gram-negative bacilli were 649 strains of Acinetobacter baumannii(28.2%),399 strains of Klebsiella pneumoniae(17.3%),and 323 strains of Pseudomonas aeruginosa(14.0%).)Escherichia coli 141 strains(6.1%)and Enterobacter cloacae 113 strains(4.9%).The four isolates with the highest detection rate among gram-positive cocci were 216 strains of Staphylococcus aureus(9.4%),35 strains of Streptiococcus pneumoniae(1.5%),28 strains of Enterococcus faecalis(1.2%),and Enterococcus faecium.19 strains(0.8%).In addition to polymyxin B,the resistance rale of Acinetobacter baumannii to other antibiotics was higher than 60%for 3 years,and the resistance rate to polymyxin B was low,and tetracycline,amikacin,mo The drug resistance rate of Xixingxing declined Klebsiella pneumoniae had low resistance to impener,meropenem,and polymyxin B,and the resistance rate to most antibiotics decreased In our hospital,399 strains of Klebsiella pneumoniae were detected,of which 38 strains produced ESBL bacteria,accounting for 9.5%,which was sigrnificantly lower with CHINET data(>30%).Compared with non-ESBL-producing Klebsiella pneumoniae,the sensitivity rate of ESBL-producing bacteria was significantly lower,and the drug-resistant rate was significantly higher.The resistance rates of Pseudomonas aeruginosa to ampicillin,ampicillin sulbactam,amoxicillin clavulanic acid,cefazolin,tetracycline,and chloramphenicol were all higher than 80%,and they were against moxifloxacin,chloramphenicol,etc.The drug resistance rate is declining year by year.The resistance rate of Escherichia coli to imipenem,meropenem,polymyxin B,piperacillin and tazobactam was low.Resistance rates to amikacin and ceftazidime remained below 20%for anpicillin,sulfadophane,amikacin,tetracycline,ciprofloxacin,trimethoprin/sulfamethoxazole Aztreonam and other drug resistance rales are declining year by year.In addition to ampicillin,ampicillin,clavulanic acid,and cefazolin,the resistance rare of Enterobacter cloacae to other antibiotics remained below 40%,and the resistance rate to amoxicillin clavulanic acid and cefazolin was highest,and it continued to rise..No Enterobacter cloacae resistant to imipenem and meropenem was found Staphylococcus aureus was the most resistant to penicillin,exceeding 80%for 3 years.Compared with 2015 and 2016,the resistance rate to various antibiotics was significantly higher in 2014.No isolates resistant to vancomycin,nitrofurantoin and teicoplanin were found The detection rate of MRSA in three years was 19.74%,20.97%,and 19.23%,respectively,with no significant difference.In addition to Acinetobacter baumannii,the common respiratory tract isolates in our hospital maintain a low resistance rate to carbapenems,and have low resistance to polymyxin B,and the resistance rate to cefazolin is close to 100.%,of which the isolate that maintained a low resistance rate was Klebsiella pneumoniae(<60%).Conclusion:1.The resistance of isolates of lower respiratory tract in our hospital is lower or far below the current relevant reports.2.The rising trend of the resistance rate of most isolates to antibiotics is considered related to the abuse of antibiotics.3.Some drug isolates were found to have decreased resistance to some antibiotics.This may be related to the strengthening of managemaent and guidance of antibacterial drugs in China’s health administration for many years.