Pathogen Characteristics And Drug Resistance Of Severe Community-acquired Infection In Emergency Ward

Objective:To understand the species and distribution of pathogens in patients with severe community-acquired infection in emergency ward;Drug resistance of pathogens to antibiotics and its changes.To provide scientific basis for empirical selection of antibacterial drugs.Method:The clinical data,pathogen culture results and drug sensitivity test results of patients with severe infection treated in EICU,First Affiliated Hospital of Nanchang University from 2014 to 2019 were collected and analyzed in combination with their clinical data.Statistical analysis was carried out by SPSS17.0,P<0.05 was statistically significant.Results:1.From 2014 to 2019,505 patients with severe community-acquired infection were treated in EICU,and 286 strains of pathogenic bacteria were detected,with a detection rate of 56.63%.2.The infection site of severe community-acquired infection was respiratory tract infection(43.96%)in turn,and it showed an increasing trend year by year.Digestive tract infection(18.81%);Blood-borne infection(17.82%);Urinary tract infection(6.14%);Central nervous system infection(5.35%);Skin and soft tissue infection(2.77%);Suppurative tonsillitis(0.20%);Pelvic infection(0.20%);Another 24patients had unknown infection source(4.75%).3.132 gram-negative bacteria(75.0%),43 gram-positive bacteria(24.43%)and 1fungus(0.57%)were detected.81 strains(46.02%)of pathogenic bacteria were from blood.57 strains of respiratory tract(32.39%);20 strains of digestive tract(11.36%);15 strains of urinary tract(8.52%);There were 3 strains of skin and soft tissue(1.70%).The main pathogenic bacteria are Escherichia E.coli(Eco)(62 strains,35.23%);Klebsiella pneumonia(Kpn)(20 strains,11.36%);Acinetobacter baumannii(Aba)(18 strains,10.23%);Staphylococcus aureus(Sau)(13 strains,7.39%);Pseudomonas aeruginsa(Pae)(11 strains,6.25%).4.127 strains of multi-drug resistance organism(MDR)were detected in pathogenic bacteria,with the detection rate of 72.16%,in order:42 strains of Escherichia coli producing extended-spectrumβ-lactamase(ESBL),the detection rate was 67.74%;15 strains of carbapenem-resistant Acinetobacter baumannii(Cr-AB),with a detection rate of 83.33%;13 strains of carbapenem-resistant enterobacteriaceae(cre);There were 5 multidrug-resistant Pseudomonas aeruginosa(MDR-PA)strains,and the detection rate was 45.45%.There were 5 Klebsiella pneumoniae strains producing ESBL,and the detection rate was 25%.Methicillin-resistant staphylococcus aureus(MRSA)were 3 strains,and the detection rate was 23.08%.2 strains of multi-drug resistant Enterobacter cloacae,the detection rate was 66.66%.5.Aba is the bacteria with high resistance rate to various antibiotics;All kinds of antibiotics sensitive to G~-bacteria are:carbenes,β-lactamase inhibitors,aminoglycosides,sulfonamides and quinolones.All kinds of antibiotics sensitive to G~+bacteria are:polypeptides,oxazolidinones,aminoglycosides,sulfonamides,quinolones and macrolides.Conclusions:1.Respiratory tract infection is the main cause of severe community-acquired infection in emergency ward,followed by blood-borne infection,G-bacteria is the main pathogen,MDR detection rate is high,and ESBL-Eco is the main cause.2.Aba resistance rate of pathogens of severe community-acquired infection in emergency ward is high.The antibiotics sensitive to G-bacteria are mainly hydrocarbons andβ-lactamase inhibitors,while the antibiotics sensitive to G+bacteria are mainly polypeptides and oxazolidinones.