Objective
To investigate the clinical characteristics and bacterial drug resistance of bloodstream infection of gram-negative bacteria, and provide guidance for clinical rational drug use and control of hospital infection.
Methods
A retrospective analysis was conducted in the patients diagnosed as severe pneumonia with blood culture of gram-negative bacteria from January 2015 to December 2017 in Beijing Anzhen Hospital.
Results
A total of 60 severe pneumonia patients suffered from bloodstream infection of gram-negative bacteria were recruited including 34 males and 26 females aging from 42 to 89 years and 73.4 years in average. In the 60 patients, 32 cases were infected with Klebsiella pneumonias, 20 cases were infected with Acinetobacter baumanni, and 8 cases were infected with Escherichia coli. The antimicrobial susceptibility testing result of Klebsiella pneumonias showed that the drug susceptibility rate was 100% to tigecycline, and 6.3% to amikacin. Escherichia coli was sensitive to Amikacin, imipenem, ceftazidime and meropenem while resistance to other drugs. The antimicrobial resistance of Acinetobacter baumanni was 28.6% for cefoperazone/sulbactam, and 14.3% for tigecycline. C-reactive protein, procalcitonin and SOFA scores were higher in the patients infected with Acinetobacter baumanni. Neutrophils and blood lactic acid were higher in the patients infected with Klebsiella pneumonias. There were no statistical differences in white blood cell, platelet or motality rate between the patients infected with Acinetobacter baumanni and the patients infected with Klebsiella pneumonias. SOFA scores and blood lactic acid had significantly statistical relevance with prognosis.
Conclusion
There is a high proportion of drug resistance of Klebsiella pneumoniae and Acinetobacter baumanni in the bloodstream infection of gram-negative bacteria.
Citation：
WU Chunting, ZHAO Jiahui, YE Xiaofang, HUANG Yan, HUANG Lixue, ZHU Guangfa. Clinical analysis of Gram-negative bacteria bloodstream infections in 60 patients. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(3): 243-246. doi: 10.7507/1671-6205.201712011
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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- 1. Soman R, Gupta N, Suthar M, et al. Antibiotic lock Therapy in the rra of Gram-negative resistance. J Assoc Physicians India, 2016, 64(2): 32-37.
- 2. Poulakou G, Kontopidou FV, Paramythiotou E, et al. Tigecycline in the treatment of infections from multi-drug resistant gram-negative pathogens. J Infect, 2009, 58(4): 273-284.
- 3. Keynan Y, Rubinstein E. The changing face of Klebsiella pneumoniae infections in the community. Int J Antimicrob Agents, 2007, 30(5): 385-389.
- 4. Maisonneuve E, Cateau E, Delouche M, et al. An observational study of phagocytes and Klebsiella pneumoniae relationships: different behaviors. Microbes Infect, 2017, 19 (4-5): 259-266.
- 5. Wasfi R, Elkhatib WF, Ashour HM. Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals. Sci Rep, 2016, 6: 38929.
- 6. Marchaim D, Levit D, Zigron R, et al. Clinical and molecular epidemiology of Acinetobacter baumannii bloodstream infections in an endemic setting. Future Microbiol, 2017, 12: 271-283.
- 7. Gulen TA, Guner R, Celikbilek N, et al. Clinical importance and cost of bacteremia caused by nosocomial multi drug resistant Acinetobacter baumannii. Int J Infect Dis, 2015, 38: 32-35.
- 8. Santimaleeworagun W, Wongpoowarak P, Chayakul P, et al. Clinical outcomes of patients infected with carbapenem-resistant Acinetobacter baumannii treated with single or combination antibiotic therapy. J Med Assoc Thai, 2011, 94(7): 863-870.
- 9. Vasudeva N, Nirwan PS, Shrivastava P. Bloodstream infections and antimicrobial sensitivity patterns in a tertiary care hospital of India. Ther Adv Infect Dis, 2016, 3(5): 119-127.
- 10. Chang CH, Chen SW, Fan PC, et al. Sequential organ failure assessment score predicts mortality after coronary artery bypass grafting. BMC Surg, 2017, 17(1): 22.
