Analysis Of Distribution And Drug Sensitivity Of Pathogens In Lower Respiratory Tract Infection

Background:Lower respiratory tract infection is the most common disease in respiratory medicine,and it is an infectious disease that seriously threatens human health and quality of life.With the increasing number of antibacterial agents available in clinic,the number of drug-resistant bacteria is also significantly increased,leading to an increase in the incidence of lower respiratory tract infection.In terms of its treatment,it is very important to identify the nature of its pathogens in the early stage and to choose reasonable,effective and efficient anti-infective drugs.Due to the long time of pathogen culture,it often lags behind the clinical practice,Therefore,it is very important for clinicians to use empiric drugs to treat patients,especially the critically ill patients.Objective:Statistics and analysis of the distribution of common pathogens and bacterial drug resistance of lower respiratory tract infection in the respiratory department of our hospital in order to provide reference for clinicians and better guide empirical medication.Methods:Statistics of patients with lower respiratory tract infection diagnosed in the respiratory department of our hospital from January 2017 to December 2018,sputum,bronchoalveolar lavage fluid,pleural puncture fluid,blood and other samples were collected,and the samples were sent for strain identification and drug sensitivity analysis.Results:The overall test delivery rate of patients with lower respiratory tract infection is 80.0%,the examination rate of the young and middle-aged group is 68.9%,and that of the elderly group is 89%.The examination rate of the elderly group is higher than that of the young and middle-aged group,which is considered to be related to the combination of a variety of diseases and good compliance.Among the 631 strains of pathogenic bacteria,gram-negative bacteria were still dominant,accounting for 69.1%.The second detection rate was fungi,accounting for 26.9%,and gram-positive bacteria accounted for 4.0%.Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,Enterobacter cloacae and Escherichia coli were more common in Gram-negative bacteria.Candida albicans still has the highest detection rate among fungi.Among the gram-positive bacteria,Staphylococcus aureus accounted for the highest proportion.Most of the gram-negative bacteria were sensitive to piperacillin / tazobactam,the fourth generation cephalosporins,ceftazidime,cefoperazone / sulbactam,carbapenem,amikacin and quinolones.The resistance rate to semisynthetic penicillin and the first and second generation cephalosporins was high.Klebsiella pneumoniae is highly resistant to ampicillin and cefuroxime,but sensitive to most other antibiotics.Pseudomonas aeruginosa is highly resistant to ampicillin,ampicillin / sulbactam,first-generation cephalosporins and second-generation cephalosporins,all above 94%.Sensitive to piperacillin,ceftazidime,cefoperazone / sulbactam,fourth generation cephalosporins,carbapenem,aminoglycosides and quinolones;Acinetobacter baumannii is more than 40% resistant to most antibiotics;Escherichia coli is resistant to most antibacterial drugs,and has good sensitivity to piperacillin/tazobactam,cefoperazone/sulbactam and other compound preparations with enzyme inhibitors,amikacin and carbapenem.Enterobacter cloacae is more sensitive to most antibiotics and has a high resistance rate to penicillins and first-and second-generation cephalosporins,which is more than 70%.The resistance rate of gram-positive bacteria to most antibiotics was more than 40%,and the resistance rate to tegacycline,vancomycin and linezolid was 0.A total of 40 ESBLs-producing strains were tested,and drug sensitivity statistics showed that the drug resistance of ESBLs-producing Klebsiella pneumoniae was generally higher than that of non-ESBLs-producing strains.Conclusion:Gram negative bacteria still play a leading role in lower respiratory infection,and have good sensitivity to piperacillin / tazobactam,the fourth generation cephalosporins,ceftazidime,cefoperazone / sulbactam,carbapenem,amikacin and quinolones.The resistance to semisynthetic penicillin,the first and second generation cephalosporins is relatively high.The resistance rate of gram-positive bacteria to most antibiotics was more than 40%,and the resistance rate to tegacycline,vancomycin and linezolid was 0.A total of 40 ESBLs-producing strains were detected.Drug sensitivity statistics showed that the drug resistance of ESBLs-producing Klebsiella pneumoniae was generally higher than that of non-ESBLs-producing strains.To understand the distribution of pathogenic bacteria and bacterial drug resistance in this area,low-cost and efficient use of antibiotics to slow down the production and spread of bacterial drug resistance.