Analysis of the characteristics of pathogenic microorganism infection and bacterial drug resistance in emergency intensive care unit / 新乡医学院学报

ABSTRACT

Objective To analyze the characteristics of pathogenic microorganism infection and the bacterial drug resistance in emergency intensive care unit (EICU),and to provide the basis for rational use of antibacterials and effective control of infection.Methods A total of 1 516 samples of infected patients were collected from 214 infected patients who were diagnosed in 628 patients from January 2015 to December 2016 in EICU of the Central Hospital of Luoyang City.The specimens were subjected to etiological detection and drug sensitivity tests.The constituent ratio of samples,positive rate of etiological examination,the constituent ratio of pathogenic bacteria,the characteristics of pathogenic microorganism infection,the classification in different infection sites,the main bacteria in different infection sites and the bacterial drug resistance were analyzed.Results The positive rate of etiological examination was 14.31％ (217/1 516),there were 186 effective positive specimens after removing duplicate samples,including 123 gram negative bacteria (66.13％),34 fungi (18.28％) and 29 gram positive bacteria (15.59％).The lower respiratory tract,urinary tract and blood system were the most common sites of infection;there were 87 strains (46.77％),39 strains (20.97％) and 32 strains (17.20％) were detected.The proportion of community infection (90.32％,168/186) was significantly higher than that of nosocomial infection (9.68 ％,18/186) (x2 =80.778,P ＜ 0.05).There was difference in the main pathogenic bacteria in different infection sites between community infection and nosocomial infection,the proportion of Acinetobacter baumannii and Stenotrophomonas maltophilia in lower respiratory tract increased in the patients with nosocomial infection,the Enterococcus faecalis were detected in urinary tract infection in the patients with nosocomial infection.The Escherichia coli and Klebsiella pneumoniae have lower resistance to carbapenems,β-1actamase inhibitors,amikacin,cefoxitin and ceftazidime.The resistance rate of Pseudomonas aeruginosa to quinolone,ceftazidime,piperacillin and sulbactam,aminoglycosides and β-1actamase inhibitors was low.42.86％ Staphylococcus aureus were oxacillin-resistant Staphylococcus aureus.Conclusion EICU patients with infection,lower respiratory tract,urinary tract and blood system were the most common infection site.The proportion of community infection is higher than that of nosocomial infection.The ventilator-associated pneumonia,urethral catheter-related urinary tract infection and catheter-related blood infection are common nosocomial infections.There are differences in the pathogenic bacteria and bacterial drug resistance in different infection sites between community infection and nosocomial infection.The common pathogens should be taken into account in the empirical selection of antimicrobial agents.