Distribution and antimicrobial resistance of major gramnegative bacilli in ICU and nonICU wards in a grassroots hospital

Abstract:

ObjectiveTo investigate the distribution and antimicrobial resistance of major gramnegative bacilli isolated from patients in intensive care unit (ICU) and nonICU wards，and provide reference for rational clinical antimicrobial  application. MethodsSpecimen sources and antimicrobial resistance of gramnegative bacilli from hospitalized patients in ICU and nonICU wards between 2011 and 2013 were analyzed statistically and compared.ResultsA total of  3 875 gramnegative bacterial isolates were detected among 25 153 specimens, isolation rate was 15.41%; 1 121 specimens from ICU were isolated 527 isolates of gramnegative bacilli， isolation rate was  47.01%; 3 348 isolates of  gramnegative bacilli were isolated from 24 032 specimens of nonICU, isolation rate was 13.93%, there was significant difference between the two（χ2=899.32，P＜0.001）. Extendedspectrum βlactamases (ESBLs)producing rate of Escherichia coli and Klebsiella pneumoniae in ICU patients was 56.00%（28/50） and 70.65%（65/92） respectively, in nonICU patients was 52.81%（517/979） and 40.37%（241/597）respectively. The imipenemresistant rate of Pseudomonas aeruginosa， Acinetobacter baumannii,  Escherichia coli, and Klebsiella pneumoniae from ICU was 36.59%, 88.54%, 10.00%, and 10.87% respectively， while from nonICU was 20.21%, 61.15%, 1.74%, and 2.85% respectively，the resistant rates of strains from ICU were higher than nonICU.ConclusionAntimicrobial resistant rates of major gramnegative bacilli from ICU are higher than those from nonICU, and the main strains are multidrugresistant nonfermentative bacteria. Clinical treatment should be different to reduce the emergence of drugresistant bacteria.