Epidemiology and antibiotic resistance of pulmonary infections in Neurosurgical Intensive Care Unit Survey

doi:10.3877/cma.j.issn.2095-9141.2017.06.005

Abstract

Abstract:

Objective

To investigate the species of pathogens causing pulmonary infections in Neurosurgical Intensive Care Unit (NSICU) and their antibiotic resistance, and offer reference for the prevention and control of pulmonary infections in NSICU.

Methods

The species and resistance pattern of bacterial isolates in NSICU of The First Affiliated Hospital of Xiamen University from June 2014 to August 2017 were collected and analyzed retrospectively. Bacterial identification and antibiotic susceptibility tests were carried out by using VITEK2 automatic system, the data was analyzed by WHONET5 software.

Results

Totally 217 strains of pathogens causing pulmonary infections were isolated, including 44 strains of Gram-positive cocci, 173 strains of Gram-negative bacilli. The top 4 isolated pathogens were Pseudomonas aeruginosa (P. aeruginosa) (22.12%), Klebsiella pneumonia (K. pneumonia) (21.20%), Staphylococcus aureus (S. aureus) (17.51%) and Acinetobacter baumannii (A. baumannii) (16.59%). The susceptible rates of S. aureus to all the antibiotics were less than 65.0% except Vancomycin (100.0%), Linezolid (100.0%), Tigecycline (100.0%), Nitrofurantoin (100.0%), Quinupristin/ Dalfopristin (100.0%) and Sulfamethoxazole (94.7%). The susceptible rates of P. aeruginosa to all the antibiotics were less than 65.0% except Amikacin (95.8%), Tobramycin (89.6%), Gentamycin (83.3%), Cefepime (77.1%) and Ceftazidime (75.0%). The susceptible rates of K. pneumonia were high in Amikacin (91.3%), Meropenem (91.3%), Pipercillin/sulbactam (91.3%), imipenem (89.1%) and Cefotetan (89.1%). while to other common antibiotics, the susceptible rates were more than 60.0% except Ampicillin (0.0%), Piperacillin (2.2%) and Nitrofurantoin (21.7%). The susceptible rates of A. baumannii to all the antibiotics were less than 30.0% except Tobramycin (33.3%).

Conclusion

The pathogens causing pulmonary infections in NSICU present a trend as highly centralize and multidrug-resistant. To emphasize on the recognition of the pulmonary infections and the antibiotic resistance of NSICU, it is important to take certain preventive measures so as to control and reduce pulmonary infections.

Key words: Neurosurgical Intensive Care Unit, Pulmonary infection, Pathogen, Antibiotic resistance

Xi Chen, Jinli Sun, Sifang Chen, Jianfeng Guo, Guowei Tan, Zhanxiang Wang. Epidemiology and antibiotic resistance of pulmonary infections in Neurosurgical Intensive Care Unit Survey[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2017, 03(06): 343-347.

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Figures/Tables 3

References 15

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细菌种类			数量	构成比(%)	细菌种类	?	数量	构成比(%)
革兰阳性球菌			44	20.28	鲍曼不动杆菌	?	36	16.59
?	金黄色葡萄球菌		38	17.51	?	普通鲍曼不动杆菌	9	4.15
?	?	普通金黄色葡萄球菌	18	8.29	?	耐碳青霉烯鲍曼不动杆菌	27	12.44
?	?	耐甲氧西林金黄色葡萄球菌(MRSA)	20	9.22	肺炎克雷伯杆菌	?	46	21.20
?	肺炎链球菌		3	1.38	?	普通肺炎克雷伯杆菌	42	19.35
?	表皮葡萄球菌		1	0.46	?	耐碳青霉烯肺炎克雷伯杆菌	4	1.84
?	屎肠球菌		1	0.46	嗜麦芽窄食单胞菌	?	8	3.69
?	B群（无乳）链球菌		1	0.46	大肠埃希菌	?	7	3.23
革兰阴性球菌			173	79.72	产气肠杆菌	?	6	2.76
?	铜绿假单胞菌		48	22.12	克氏枸橼酸杆菌	?	4	1.84
?	?	普通铜绿假单胞菌	37	17.05	流感嗜血杆菌	?	3	1.38
?	?	耐碳青霉烯铜绿假单胞菌	11	5.07	奇异变形杆菌	?	3	1.38
?	副流感嗜血杆菌		1	0.46	洋葱伯克霍尔德菌	?	3	1.38
?	产碱假单胞菌		1	0.46	阴沟肠杆菌	?	2	0.92
?	恶臭假单胞菌		1	0.46	脑膜脓毒性伊丽莎白菌	?	2	0.92
?	琼氏不动杆菌		1	0.46	粘质沙雷氏菌	?	1	0.46
?	?		?	?	合计		217	100.00

细菌种类			数量	构成比(%)	细菌种类	?	数量	构成比(%)
革兰阳性球菌			44	20.28	鲍曼不动杆菌	?	36	16.59
?	金黄色葡萄球菌		38	17.51	?	普通鲍曼不动杆菌	9	4.15
?	?	普通金黄色葡萄球菌	18	8.29	?	耐碳青霉烯鲍曼不动杆菌	27	12.44
?	?	耐甲氧西林金黄色葡萄球菌(MRSA)	20	9.22	肺炎克雷伯杆菌	?	46	21.20
?	肺炎链球菌		3	1.38	?	普通肺炎克雷伯杆菌	42	19.35
?	表皮葡萄球菌		1	0.46	?	耐碳青霉烯肺炎克雷伯杆菌	4	1.84
?	屎肠球菌		1	0.46	嗜麦芽窄食单胞菌	?	8	3.69
?	B群（无乳）链球菌		1	0.46	大肠埃希菌	?	7	3.23
革兰阴性球菌			173	79.72	产气肠杆菌	?	6	2.76
?	铜绿假单胞菌		48	22.12	克氏枸橼酸杆菌	?	4	1.84
?	?	普通铜绿假单胞菌	37	17.05	流感嗜血杆菌	?	3	1.38
?	?	耐碳青霉烯铜绿假单胞菌	11	5.07	奇异变形杆菌	?	3	1.38
?	副流感嗜血杆菌		1	0.46	洋葱伯克霍尔德菌	?	3	1.38
?	产碱假单胞菌		1	0.46	阴沟肠杆菌	?	2	0.92
?	恶臭假单胞菌		1	0.46	脑膜脓毒性伊丽莎白菌	?	2	0.92
?	琼氏不动杆菌		1	0.46	粘质沙雷氏菌	?	1	0.46
?	?		?	?	合计		217	100.00

抗菌药物	PAE(n=48)		KPN(n=46)		ABA(n=36)		PMA(n=8)		ECO(n=7)
抗菌药物	株数	敏感率	株数	敏感率	株数	敏感率	株数	敏感率	株数	敏感率
阿米卡星	46	95.8	42	91.3	-	-	-	-	7	100.0
氨苄西林	0	0.0	0	0.0	0	0.0	-	-	1	14.3
氨苄西林/舒巴坦	0	0.0	27	58.7	9	25.0	-	-	1	14.3
氨曲南	-	-	32	69.6	0	0.0	-	-	4	57.1
头孢他啶	36	75.0	37	80.4	8	22.2	8	100.0	4	57.1
头孢唑啉	0	0.0	-	-	0	0.0	-	-	0	0.0
环丙沙星	31	64.6	32	69.6	9	25.0	-	-	3	42.9
头孢曲松	0	0.0	28	60.9	0	0.0	-	-	2	28.6
头孢替坦	0	0.0	41	89.1	0	0.0	-	-	7	100.0
头孢呋肟酯	0	0.0	28	60.9	0	0.0	-	-	2	28.6
头孢呋辛	0	0.0	28	60.9	0	0.0	-	-	2	28.6
头孢吡肟	37	77.1	34	73.9	9	25.0	-	-	5	71.4
庆大霉素	40	83.3	39	84.8	9	25.0	-	-	6	85.7
亚胺培南	21	43.8	41	89.1	8	22.2	-	-	7	100.0
左旋氧氟沙星	28	58.3	35	76.1	9	25.0	7	87.5	4	57.1
美罗培南	28	58.3	42	91.3	7	19.4	-	-	7	100.0
呋喃妥因	0	0.0	10	21.7	0	0.0	-	-	6	85.7
哌拉西林	26	54.2	1	2.2	5	13.9	-	-	1	14.3
哌拉西林/舒巴坦	24	50.0	42	91.3	7	19.4	-	-	6	85.7
妥布霉素	43	89.6	36	78.3	12	33.3	-	-	6	85.7
复方新诺明	0	0.0	28	60.9	9	25.0	8	100.0	2	28.6

抗菌药物	PAE(n=48)		KPN(n=46)		ABA(n=36)		PMA(n=8)		ECO(n=7)
抗菌药物	株数	敏感率	株数	敏感率	株数	敏感率	株数	敏感率	株数	敏感率
阿米卡星	46	95.8	42	91.3	-	-	-	-	7	100.0
氨苄西林	0	0.0	0	0.0	0	0.0	-	-	1	14.3
氨苄西林/舒巴坦	0	0.0	27	58.7	9	25.0	-	-	1	14.3
氨曲南	-	-	32	69.6	0	0.0	-	-	4	57.1
头孢他啶	36	75.0	37	80.4	8	22.2	8	100.0	4	57.1
头孢唑啉	0	0.0	-	-	0	0.0	-	-	0	0.0
环丙沙星	31	64.6	32	69.6	9	25.0	-	-	3	42.9
头孢曲松	0	0.0	28	60.9	0	0.0	-	-	2	28.6
头孢替坦	0	0.0	41	89.1	0	0.0	-	-	7	100.0
头孢呋肟酯	0	0.0	28	60.9	0	0.0	-	-	2	28.6
头孢呋辛	0	0.0	28	60.9	0	0.0	-	-	2	28.6
头孢吡肟	37	77.1	34	73.9	9	25.0	-	-	5	71.4
庆大霉素	40	83.3	39	84.8	9	25.0	-	-	6	85.7
亚胺培南	21	43.8	41	89.1	8	22.2	-	-	7	100.0
左旋氧氟沙星	28	58.3	35	76.1	9	25.0	7	87.5	4	57.1
美罗培南	28	58.3	42	91.3	7	19.4	-	-	7	100.0
呋喃妥因	0	0.0	10	21.7	0	0.0	-	-	6	85.7
哌拉西林	26	54.2	1	2.2	5	13.9	-	-	1	14.3
哌拉西林/舒巴坦	24	50.0	42	91.3	7	19.4	-	-	6	85.7
妥布霉素	43	89.6	36	78.3	12	33.3	-	-	6	85.7
复方新诺明	0	0.0	28	60.9	9	25.0	8	100.0	2	28.6

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