Analyze Pathogen Distribution And Drug Resistance For Very Severe-burned Patients

Objective:Retrospective study of designed to evaluate pathogen distribution and drug resistance involved in very severe-burned patients at our hospital from 2016 to 2018.This study could both provide reference and reasonable basis for clinical diagnosis as early as possible,and help clinicians to select appropriate medication procedure.1t is also reduce the occurrence of multiple drug resistance and improve the success rate of burn treatment.Methods:Retrospective study of designed to evaluate pathogen distribution and drug resistance involved in very severe-burned patients at our hospital from 2016 to 2018.Statistical analysis was performed to investigate the type of specimens and strains and the resistance rates of major pathogens.Chi-square test was used to compare the changes of the detection rates and drug resistance rates of major pathogens between2016,2017and2018.When the ? 2 test condition is not satisfied,Fisher exact probability method is used,P < 0.05 indicates that there is statistical difference,P < 0.01 indicates that there is significant statistical difference.Results:Among the 395 pathogens collected from 105 patients,173 were from blood,120 from wound,73 from respiratory tract,23 from urinary tract and 6 from vein catheterization.There were 316(80.00%)gram-negative(G-)strains,57(14.43%)Gram-positive(G-)strains and 22(5.57%)fungi.From 2016 to 2018,G-bacteria accounted for 76.73%,80.67% and 83.76% respectively;G + bacteria accounted for 20.13%,12.61% and 8.55% respectively;fungi accounted for 3.14%,6.72% and 7.69% respectively.The top four pathogens were Acinetobacter baumannii(36.96%),Pseudomonas aeruginosa(20.76%),Klebsiella pneumoniae(10.89%)and Staphylococcus aureus(10.63%)were the top four bacteria.The resistance rates of Acinetobacter baumannii to levofloxacin,amikacin and tetracycline were 53.42%,75.34% and 78.76%,respectively.The resistance rates of Acinetobacter baumannii to other antibiotics were more than 80%.The resistance rates of Pseudomonas aeruginosa to levofloxacin,aztreonam,ciprofloxacin and meropenem were 60.98%,68.29%,64.63% and 53.66%,respectively,and the resistance rate to meropenem was on the rise.In 2018,the resistance rate of Pseudomonas aeruginosa to imipenem was 62.50%,and the resistance rate to other antibiotics was more than 95%.The resistance rates of Klebsiella pneumoniae to meropenem and tegacyclin were 48.84% and51.16%,respectively.The resistance rates of Klebsiella pneumoniae to other antibiotics were more than 60%,and most of them were 70%-80%.Staphylococcus aureus is sensitive to vancomycin,linezolid and quinupine / dafop,but not to gentamicin and ciprofloxacin.Conclusions:1.From 2016 to 2018,the distribution of pathogenic bacteria in our hospital was mainly Gram-negative bacteria,Gram-positive bacteria had a downward trend,while fungi had an upward trend.2.From 2016 to 2018,Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and Staphylococcus aureus were the top four pathogens with positive rate from high to low.3.Acinetobacter baumannii has a high resistance rate,Pseudomonas aeruginosa has a rising resistance rate,Klebsiella pneumoniae is sensitive to tegacyclin to a certain extent.Staphylococcus aureus is highly sensitive to vancomycin,linezolid and quinupine / daffodil.