Distribution of the pathogens and their drug resistance in patients with lower respiratory tract infection in Intensive Care Unit / 中国实用内科杂志

ABSTRACT

Objective To investigate pathogens and drug resistance of lower respiratory tract infection(LRTI)in Intensive Care Unit(ICU).Methods Retrospective study of the clinical data,the distribution and the drug-sensitivity of pathogens of 220 cases with LRTI in ICU.Results Totally 280 strains of pathogens were identified by bacterial culturing.The ratio of G-bacteria to total pathogens isolated was 63.5%,of the G+ bacteria was 25.1%,and of the fungi was 11.4%.The main kinds of the G-bacteria were Klebsiella pneumoniae(17.1%),Pseudomonas aeruginosa(13.2%),Acinetobacter baumannii(12.5%),and Stenotrophomonas maltophilia(10.4%).Staphylococcus aureus(SA)(91.4%)was the most prominent in G+ bacteria,and MRSA was 98.4% in SA.The result of drug sensitive test in vitro showed the multiple drug fast rate of Pseudomonas aeruginosa was comparatively high,Stenotrophomonas maltophilia to Levofloxacin was low,Klebsiella pneumoniae and Acinetobacter baumannii were highly sensitive to carbapenems.The susceptibility rate of MRSA to vancomycin was 100%.Conclusion G-bacteria are the majority of the pathogens,isolated from patients with LRTI in ICU.Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,and Stenotrophomonas maltophilia are the chief G-pathogens.Except Stenotrophomonas maltophilia,imipenem and merpenem are relatively active against the G-bacilli.The proportion of MRSA and fungal infection is increasing.It is suggested that there be urgent need for surveillance of bacterial resistance and rational use of antimicrobial agents during clinical therapy.