Distribution And Drug Resistance Of Bloodstream Infection Bacteria In 2268 Hospitalized Patients

Objective:A retrospective analysis of the composition,distribution,and drug resistance of pathogens in bloodstream infections in inpatients of the First Affiliated Hospital of China Science and Technology(Anhui Provincial Hospital),to guide clinicians to standardize the rational application of anti-infective drugs.Methods: Collect the results of pathogenic bacteria strains and drug susceptibility test results of inpatients with bacterial bloodstream infections admitted to the First Hospital Affiliated to China Science and Technology(Anhui Provincial Hospital)from January 1,2016 to December 31,2018.The composition and susceptibility of common antibacterials were statistically analyzed.At the same time,the distribution of patients with bloodstream infections was analyzed,and the distribution and drug resistance of pathogenic bacteria in each department were statistically analyzed.Results: A total of 2268 pathogenic strains causing bloodstream infections were isolated during 3 years,of which 1197 were Gram-negative bacteria,accounting for52.78%.The top four Gram-negative bacteria were 506 Escherichia coli(22.31%).263cases(11.60%)of Klebsiella pneumoniae,107 cases(4.72%)of Pseudomonas aeruginosa and 80 cases(3.53%)of Acinetobacter baumannii.1071(47.22%)Gram-positive bacteria were isolated.The top three Gram-positive bacteria were 718(31.66%)coagulase-negative staphylococci,129(5.69%)Enterococcus faecium,and108(4.76%)Staphylococcus aureus.The top 6 departments for the incidence of bloodstream infections are blood medicine(442 cases,19.49%),intensive medicine(409 cases,18.03%),general surgery(271 cases,11.95%),and pediatric medicine(180cases,accounting for 7.93%),geriatrics(115 cases,accounting for 5.07%),emergency department(97 cases,accounting for 4.28%),and other departments with a total of 754 cases,accounting for 33.25%.Analysis of drug resistance of the isolated bacteria showed that the detection rates of Extended spectrum ?-lactamases(ESBLs)positive Escherichia coli and Klebsiella pneumoniae were 64.23% and 31.94%.Escherichia coli and Klebsiella pneumoniae remained sensitive to amikacin and piperacillin / tazobactam.The resistance rates of the two types of bacteria to carbapenems are slightly different.They are 3.6% Escherichia coli resistant to imipenem and 30.0% Klebsiella pneumoniae resistant to imipenem.The resistance rates of P.aeruginosa to piperacillin tazobactam,ceftazidime,levofloxacin,ciprofloxacin,gentamicin,amikacin,and gentamicin are all less than 20%.The southern drug resistance rate is 21.5%.The resistance rate of Acinetobacter baumannii to cephalosporins,piperacillin and tazobactam and ciprofloxacin are all above 70%,and the resistance rate to imipenem is as high as 76.2%.Among coagulase-negative staphylococci,methicillin-resistant coagulase-negative staphylococci accounted for 76.7%,and methicillin-resistant Staphylococcus aureus(MRSA)in S.aureus accounted for 41.7%.Both mycin and linezolid were sensitive.The resistance rate to vancomycin in Enterococcus faecium was 4.7%,and the sensitivity rate of Enterococcus faecium to high-concentration gentamicin and high-streptomycin was 100%.Enterococci resistant to linezolid and tigecycline were not isolated.Conclusion:Gram-negative bacteria were detected in the blood culture of patients with bloodstream infection in our hospital.Gram-negative bacteria were detected more than Gram-positive bacteria.Coagulase-negative staphylococci are the most common.Due to the wide distribution of patients in our hospital with bloodstream infections,the composition and drug resistance of pathogens isolated from bloodstream infections in different departments are different.The analysis of drug resistance in the whole hospitalshows that the resistance rate of bacteria in our hospital to common antibacterial drugs is comparable to the average level reported by the National Drug Surveillance Network.However,carbapenem-resistant Klebsiella pneumoniae,Acinetobacter baumannii,and methicillin-resistant coagulase-negative staphylococci have a high isolation rate,which requires high clinical attention.