Analysis Of Common Pathogens And Their Antibiotic Susceptibility Of The Preterm Infants With Infection In Recent 5 Years

Objective1.To study common pathogens and their antibiotic susceptibility of the preterm infants with infection in recent 5 years,so that pediatricians can choose effective antimicrobial agents rationally and timely.2.Compare the change in the distribution of pathogens and the antibiotic susceptibility between 2014-2018 and 1997-2007 in terms of the preterm with infection to help pediatricians choose effective antimicrobial agents before getting the laboratory culture results.3.To study the risk factors of the unfavourable prognosis of the preterm infants with infection.MethodsRetrospective analysis was performed on the cases of preterms with infection in our hospital from January 2014 to December 2018,different kinds of specimens of them were sent to the clinical lab,we mainly focus on the positive results and analysis the data of pathogens and their drug sensibility results.Then compare the data with what we already know in 1997 to 2007.Especially,we collected the associated clinical characteristics of preterms with pneumonia from January 2014 to June 2018.Results1.As for the preterms with infection in recent 5 years,950 pathogenic strains were isolated,including gram-negative strains(79.05%),gram-positive strains(10.11%)and strains of fungus(10.56%).Klebsiella pneumonia,Escherichia coli,Acinetobacter baumannii and Pseudomonas aeruginosa are the main pathogens.2.Compared with the data of 1997 to 2007,the percentage of Klebsiella pneumonia increased remarkablely,the percentage of Escherichia coli did not change too much,as for Pseudomonas aeruginosa,Staphylococcus aureus and Staphylococcus epidermidis,the proportion decreased.3.The drug resistance rate of Klebsiella pneumoniae to ceftazidime,cefepime,piperacillin/tazobactam,cefoperazone/sulbactam,imipenem and meropenem was higher in 2014-2017 than other stages,reaching 70%-100%.The drug resistance rate of above drugs decreased in 2018,but still above 30%.4.The drug resistance rate of Escherichia coli to piperacillin/tazobactam,cefoperazone/sulbactam,imipenem and meropenem fluctuated between 0 and 25% at all time stages.The drug resistance rate of Pseudomonas aeruginosa to cefepime gradually decreased to 0,the drug resistance rate to imipenem increased year by year,reaching about 54% in 2018,and the sensitivity rate to cefoperazone/sulbactam and meropenem was high.Staphylococcus is highly sensitive to vancomycin.5.Birth weight <1000 g,pulmonary hemorrhage and mechanical ventilation?14d are the independent risk factors for poor prognosis of premature pneumonia.Conclusions1.From January 2014 to December 2018,gram-negative bacteria dominated the pathogenic bacteria cultured from the infected parts of premature infants in our hospital,Klebsiella pneumoniae accounted for the highest proportion,while gram-positive bacteria and fungi accounted for the lower proportion.2.Compared with the data of pathogen infection of premature infants from October 1997 to October 2007,the proportion of Klebsiella pneumoniae and Acinetobacter baumannii increased in the past five years,while that of Pseudomonas aeruginosa,Staphylococcus aureus and Staphylococcus epidermidis decreased.3.The resistance of Klebsiella pneumoniae to commonly used drug in different stages were in a downward trend after rising first.The resistance of Acinetobacter baumannii to many common drugs in 2018 were also in a downward trend.We can see that the various measures we took to control the nosocomial infection are fruitful,however the highly resistance of pathogenic bacteria to many common drugs is still a serious problem.4.The drug resistance rates of Escherichia coli and Pseudomonas aeruginosa against ceftazidime,cefepime,piperacillin/tazobactam,cefoperazone/sulbactam,imipenem,meropenem and other commonly used drugs in clinical practice are low,but the drug resistance rates of Pseudomonas aeruginosa against imipenem are gradually increasing,which should be paid great attention to.5.Low birth weight,pneumorrhagia and mechanical ventilation required at 2 weeks after birth are risk factors of the unfavourable prognosis of premature infant with peumonia which should arise our attention.