| Objective: To study the pathogen distribution and the drug resistance of bacteria during the period from 2015 to 2016 in the intensive care unit(ICU)of the Fourth Hospital of Hebei Medical University,so as to provide bacteriological evidence for clinical application of antibiotics.Methods: A retrospective survey method was taken to collect specimens of infection patients from January 2015 to December 2016.Then the bacteria was cultured?separated?identified and drug sensitive test were done in ICU of the Fourth Hospital of Hebei Medical University.Meanwhile,clinical distribution and drug resistance of pathogenic bacteria were statistically analyzed using Excel and SPSS 21.0 software.Results:1 The amount of specimens sent by the pathogens in the ICU of the Fourth Hospital of Hebei Medical University increased,while the positive detection rate of pathogens significantly decreased in 2016 compared with 2015(P<0.05).2 The samples of pathogenic bacteria in 2015 and 2016 were mainly from the department of thoracic surgery(28.68% and 33.11% respectively)and the emergency(28.68% and 18.54% respectively).The pathogenic bacteria detected in 2015 and 2016 were mainly sputum samples(75.24% and 61.24% respectively),other samples included hydrothorax,blood,ascites,urine,etc.3 Among the pathogenic bacteria detected in 2015 and 2016,gram negative bacteria accounted for the main parts(79.68% and 81.76% respectively),and a total of 251 strains of gram negative bacteria were detected in each year.Among them,the top five were Acinetobacter baumanii,Pseudomonas aeruginosa,Klebsiella pneumonia and subspecies,Escherichia coli,and Stenotrophomonas maltophilia.Compared with gram negative bacteria,the proportion of gram positive bacteria was relatively less.A total of 54 strains of G+ were detected in 2015,and 44 strains in 2016,which mainly included Staphylococcus aureus and Enterococcus faecium,and Enterococcus faecium was increased.The proportion of fungi was least,and Candida albicans was dominated.4 The drug resistance of the main pathogens is as follows:(1)The resistance rate of Acinetobacter baumanii was generally high.Both in 2015 and 2016,the resistance rate of acinetobacter baumannii to amikacin was relatively low.For ampicillin/sulbactam,levofloxacin and tobramycin,the drug resistance rates significantly decreased in 2016 than that in 2015(P < 0.05),while the drug resistance rate to ceftazidine significantly increased(P <0.05).For other antimicrobial agents,the resistance rates of Acinetobacter baumannii were more than 60%.(2)The resistance rates of Pseudomonas aeruginosa to amikacin,piperacillin,piperacillin/tazobactam,cefepime and ceftazidime were increased in 2016 than that in 2015.While,the resistance rates of aztreonam,meropenem,and imipenem decreased in 2016 than that in 2015.(3)The resistance rates of Klebsiella pneumoniae and subspecies to ampicillin/sulbactam,piperacillin,ceftriaxone,cefuroxime and cefuroxime axetil significantly decreased in 2016 than that in 2015(P <0.05).(4)The drug resistance rate of Escherichia coli was generally low.Compared with that in 2015,there was a significant decrease in the resistance rates of Escherichia coli to piperacillin and piperacillin / tazobactam in 2016(P <0.05).However,the resistance rates to compound sulfamethoxazole and cefotetan increased.(5)The resistance rates of Staphylococcus aureus to vancomycin and linezolid was zero,and the resistance rates to other antibiotics decreased in 2016 compared with that in 2015.(6)The drug resistance rate of enterococcus faecium to quinoputin/dafopentin,vancomycin,and linezolid was zero,and the resistance rates to other antibiotics had no difference in 2015 and 2016.Conclusion: In 2016,the amount of specimens sent by the pathogens in the ICU of the Fourth Hospital of Hebei Medical University increased,while the positive rate of pathogens decreased than that in 2015.Gram-negative bacteria were the main pathogens of infections within the two years.Among them,Acinetobacter baumannii and Pseudomonas aeruginosa were the main pathogens,and the drug resistance was serious.However,both of them had low resistant rate to amikacin.Gram-positive bacteria were mainly Staphylococcus aureus and Enterococcus faecium,both of which had low resistance to vancomycin and linezolid.Compared with that in 2015,the resistance rates of Acinetobacter baumannii,Pseudomonas aeruginosa and Staphylococcus aureus were all lower in 2016,while the resistance rate of Enterococcus faecium did not change significantly. |
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