Distributon Trend Of Pathogenic Bacteria And Analysis Of Drug Resistance In Lower Respiratory Tract Infection

Objective: To understand the changing trend of pathogenic bacteria and drug resistance of lower respiratory tract infection and to provide a theoretical basis for rational selection of antibiotics for clinical workers.Methods: A retrospective study of hospitalized patients diagnosed with lower respiratory tract infection in respiratory department of First Affiliated Hospital of Hebei North University during the period of2014.01-2016.12 was carried out,and 3481 medical records of sputum samples were left.We sort the results of sputum separation and describe the trend of distribution of pathogenic bacteria in 3 years.At the same time,the non fermenting gram negative bacilli were counted,and the changes in the 3 years were described.Objective to investigate the susceptibility of 20 common antibacterial agents and common gram positive bacteria to 21 commonly used antibiotics in the past 3 years,and to explore the trend of drug resistance of the common Gram negative bacilli and Gram positive bacteria.Results: In this study,594 strains of pathogenic bacteria were isolated from 3481 sputum specimens,the detection rate was 17.06%,and the detection rate was low.Of which 563 strains were gram negative bacteria,which accounted for 94.78%,includeing:91 strains of Klebsiella pneumonia ? 65 strains of Pseudomonas aeruginosa ? 62 strains of Enterobacter cloacae?54 strains of Bauman Acinetobacter?43 strains of Escherichia coli.Their constituent ratios were 15.32%,10.94%,10.44%,9.09%,and 7.24%.The above bacteria were in the top five of the gram-negative bacilli in our hospital.At the same time,many kinds of gram-negative bacilli have been found to be pathogenic bacteria.There were 40 of them after 20.The composition ratio is 6.73%.A total of 31 strains of gram positive cocci,accounted for 5.23%,including 16 strains of Staphylococcus aureus,3 strains of Staphylococcus equorum,2 strains of Staphylococcus,2 strains of Staphylococcus saprophyticus,respectively:2.69%,0.51%,0.34%,0.34%.The analysis of the medical records showed that there was no fungal isolation and drug sensitivity test in the sputum specimens sent for inspection,and this study was short of fungi related data.A total of 248 strains of non fermentative bacteria were detected in 3years,and the constituent ratio was 41.75%.The number of trees detected in 2014,2015 and 2016 and the proportion of the year were 104(41.94%),68(40.96%),76(42.22%).The top three in the 3 years were Pseudomonas aeruginosa,Acinetobacter Bauman and Acinetobacter laumannii,and the latter two showed an upward trend.Tracking nearly three years of Common Gram negative bacilli susceptibility results,discovery of carbapenem meropenem and imipenem in Pseudomonas aeruginosa(9.6%,17.5%)and Bauman acinetobacter(28.3%,25%)slightly higher resistance rate.The sensitivity to other common pathogenic bacteria was more than97.8%.found carbapenem meropenem and imipenem is generally high sensitivity and other low resistance rate to aminoglycosides,gentamicin and amikacin;the second generation cephalosporin(ceftazidime),the fourth generation cephalosporins(cefepime)and penicillin enzyme inhibitor piperacillin / tazobactam.The average drug resistance rate was 6.56%,12.12%,13.62%,22.34% and 25.78%.The group with the worst overall sensitivity was cefazolin,a generation of cephalosporin,followed by ampicillin,amoxicillin which is a compound of penicillin,and moxifloxacin.The average tolerance rate was 75.04%,71.42%,46.66%,46.58%.Penicillium carbon alkene antimicrobial agents is pneumonic klebsiella,e.coli,sewer e.coli and other gram-negative bacillus with the highest sensitivity of antimicrobial agents,for pseudomonas aeruginosa,acinetobacter baumannii is no longer a choice for anti-infection drugs.Tetracycline and Amikacin have a certain sensitivity to Pseudomonasaeruginosa.When infected by Enterobacter cloacae,the highest sensitive drug include meropenem ? imipenem and amikacin.It is not found at present the Enterobacter cloacae have resistance about the above three drugs.Meropenem and imipenem in Bauman Acinetobacter is less sensitive than other common gram negative bacilli.The lowest rate of drug resistance is Bactrim and the rate is 16.7%.Gram-positive cocci,represented by Staphylococcus aureus,are extensively drug-resistant.However,it is sensitive to nitrofurantoin,linezolide and vancomycin.Conclusion:1.At present,the detection rate of clinical etiology is low.The main pathogenic bacteria of lower respiratory tract infection were gram-negative bacilli and gram-positive cocci,among which the highest proportion was gram-negative bacilli.2.The top five gram-negative bacilli were Klebsiella pneumoniae,Pseudomonas aeruginosa,Enterobacter cloacae,Acinetobacter Bauman,Escherichia coli.Among them,the constituent ratio of Bauman's Acinetobacter infection increased.3.Most gram negative bacilli are highly sensitive to carbapenem antibiotics and beta lactam antibiotics / enzyme inhibitors.Carbapenem antibiotics have no antibacterial activity against Pseudomonas aeruginosa and Acinetobacter baumannii and their antibacterial activities against other gram negative bacilli.4.Vancomycin is still the first choice for Staphylococcus aureus infection.