Distribution and antimicrobial resistance of pathogens from intensive care unit patients’ sputum obtained through fiberbronchoscope for four consecutive years

Abstract:

ObjectiveTo investigate the distribution and antimicrobial resistance of pathogens from lower respiratory tract in patients in intensive care unit (ICU), so as to provide reference for clinical treatment.MethodsDistribution and antimicrobial susceptibility of pathogens isolated from ICU patients’ sputum obtained through fiberbronchoscope between 2011 and 2014 were analyzed retrospectively.ResultsA total of 3 454 pathogenic strains were isolated between January 1,2011 and December 31,2014, the percentage of gramnegative bacteria, grampositive bacteria,and fungi were 84.11%, 14.50%, and 1.39% respectively. The detection rates of extendedspectrum βlactamaseproducing Escherichia coli and Klebsiella spp. in 2011-2014 were 38.46%-73.33% and 26.95%-37.06% respectively. Enterobacteriaceae strains had low resistance rates to imipenem and meropenem (<20.00%); resistance of Acinetobacter baumannii was higher than Pseudomonas aeruginosa, both had low resistance rates to amikacin(3.32%-37.16%); vancomycin and linezolidresistant strains were not found among Staphylococcus. In 2011-2014, detection rates of methicillinresistant Staphylococcus aureus(MRSA) were 42.86%-61.22%, methicillinresistant coagulasenegative staphylococcus (MRCNS) were 86.96%-91.67%; resistance rates of Enterococcus faecium was higher than Enterococcus faecalis, vancomycinresistant strains were not found among Enterococcus faecalis and Enterococcus faecium; the major fungus was Candida albicans.ConclusionAntimicrobial resistance of pathogens isolated from lower respiratory tract is getting more serious, clinicians should pay attention to nonantimicrobial infection control strategies in addition to rational use of antimicrobial agents.