Analysis Of Bacterial Spectrum And Drug Resistance Distribution Of ICU-Acquired Bacterial Infections

Background&ObjectiveBacterial infections are a frequent cause of hospitalization,and nosocomial infections are an increasingly common condition,particularly within the acute/critical care setting.An estimated650 000 individuals experience health care-associated infections in US hospitals each year,more than 20%of which are caused by antimicrobial-resistant pathogens.The emergence of antibiotic resistance and the limited available treatment options present an increasing challenge for the management of bacterial infections.Over the past 15 to 20 years,infection control practices and new antimicrobial development have primarily targeted control and treatment of infections caused bygram-positive bacteria.During this time,the incidence of infections caused by gram-negative bacteria in intensive care unts(ICUs)has risen,and the lack of available treatment options against some multidrug-resistant(MDR)strains is alarming.The spread of antibiotic-resistant infections in the ICU isespecially troublesome because these hospital units are confined to environments with seriously ill patients who are highly vulnerable to infection and who frequently require antibiotics to improve their likelihood of survival.To investigate the bacterial spectrum and bacterial resistance distribution of ICU-acquired bacterial infections in a hospital of Guangzhou,so as to provide reference for the rational use of antibiotics.Methods(1)A retrospective survey and analysis of the bacterial spectrum and bacterial resistance distribution in 430 bacterial culture positive patients admitted to ICU of South Third Hospital in recent 3 years(2014.1-2016.12)were conducted.(2)Method of investigation:According to the hospital inpatient system,inquire about the cases of ICU inpatients during 2014.1-2016.12,retrospectively analyze the cases of positive bacterial culture that meet the inclusion and exclusion criteria.(3)Data collection:design case questionnaire to collect relevant data of patients,including sex,age,basic diseases,concomitant diseases(hypertension,diabetes,etc.),disease severity score,length of hospital stay,prognosis,,The use of antibiotics,the use of other drugs(drags to enhance immunity,hormones,etc.),bacterial resistance.The survey is in Appendix 1.(4)data entry,collation and analysis:Epidata 3.1 input data,SPSS 17.0 analysis of data,data analysis includes two parts:one part is the bacterial spectrum characteristics analysis,including analysis of drug resistance of different bacteria,bacterial resistance changes over time Etc.The second part is the analysis of the related factors of drug-resistant bacterial infection,screening possible related factors.Measurement data with x ± s said;count data with n(%)that the measurement data using F test;count data using the chi-square test;using logistic regression analysis.With a = 0.05,P<0.05 was considered statistically significant.ResultsThere were 788 strains of bacteria cultured from 430 patients,gram-negative bacteria accounted for 73.4%.The bacterial samples were mainly from sputum(62.3%),followed by blood(14.2%)and urine(10.7%).Strains acquired in ICU mainly were acinetobacterbauman(23.6%),pseudomonasaeruginosa(1 3.6%),klebsiellapneumoniae(12.9%),staphylococcus aureus(12.6%),and E.coli(8.1%).Acinetobacterbaummann has high resistance rates.The resistance rate of Acetobacter baumannii to antibiotics such as piperazepine and ceftazine was higher than 80%,and the resistance rate to sulfamethoxazol/methoxoprim was 58.6%.Escherichia coli is 100%sensitive to imamipenem;Feiyankeleibojun maintained a high sensitivity rate for Ethanepenan,imine Penan,and Meropenan,with drug resistance rates of 8.82%?6.86%,and 8.82%respectively;Staphylococcus aureus is 100%sensitive to dallomycin and vancomycin;Pseudomonas aeruginosa has a high sensitivity to amikacin and gentamicin,with resistance rates of 10.28%and 13.08%?respectively.ConclusionICU acquired bacterial infections mainly were gram-negative bacteria infections.Acinetobacterbaumannella has high infection rate and high resistance rates,which should be taken seriously.