Analysis on the Antibiotics Resistance and Risk Factors of Multidrug Resistant Bacteria in Respiratory Intensive Care Unit_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

YANG Hui , XIANG Pingchao , GUO Weian , SUN Jia , SONG Liping , ZHANG Suo.

Department of Respiratory and Critical Care Medicine, Shougang Hospital Affiliated to Peking University. Beijing, 100144, ChinaCorresponding Author: XIANG Ping-chao, E-mail: xpcemail@ sohu. com;

Corresponding author：

Keywords：

Respiratory intensive care unit; Multidrug-resistant bacteria; Pandrug-resistant bacteria; Risk factors

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Objective To investigate the antibiotic resistance distribution and profiles of multidrug resistant bacteria in respiratory intensive care unit ( RICU) , and to analyze the related risk factors for multidrug resistant bacterial infections. Methods Pathogens from79 patients in RICU from April 2008 to May 2009 were analyzed retrospectively. Meanwhile the risk factors were analyzed by multi-factor logistic analysis among three groups of patients with non-multidrug, multidrug and pandrug-resistant bacterial
infection. Results The top three in 129 isolated pathogenic bacteria were Pseudomonas aeruginosa ( 24. 0% ) , Staphylococcus aureus( 22. 5% ) , and Acinetobacter baumannii( 15. 5% ) . The top three in 76 isolated multidrug-resistant bacteria were Staphylococcus aureus ( 38. 9% ) , Pseudomonas aeruginosa ( 25. 0% ) , and Acinetobacter baumannii( 19. 4% ) . And the two main strains in 29 isolated pandrug-resistant bacteria were Pseudomonas aeruginosa ( 48. 3% ) and Acinetobacter baumannii ( 44. 8% ) . Multi-factor logistic analysis revealed that the frequency of admition to RICU, the use of carbapenem antibiotics, the time of mechanical ventilation, the time of urethral catheterization, and complicated diabetes mellitus were independent risk factors for multidrug-resistant bacterial infection( all P lt; 0. 05) . Conclusions There is a high frequency of multidrug-resistant bacterial infection in RICU. Frequency of admition in RICU, use of carbapenem antibiotics, time of mechanical ventilation, time of urethral catheterization, and complicated diabetes mellitus were closely related withmultidrug-resistant bacterial infection.

Citation： YANG Hui,XIANG Pingchao,GUO Weian,SUN Jia,SONG Liping,ZHANG Suo.. Analysis on the Antibiotics Resistance and Risk Factors of Multidrug Resistant Bacteria in Respiratory Intensive Care Unit. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(1): 19-22. doi: Copy

1.	王东浩,王伟,王勇强,等.重症监护病房获得性细菌感染临床调查.中华医院感染学杂志,2004,14:151-153.
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6.	Tenover FC.Novel and emerging mechanisms of antimicrobial resistance in nosocomial pathogens. Am J Med,1991,91:76S-81S.
7.	Smith SM,Eng RK,Tecson-Tumany F.Ciprofloxacin therapy for methicillin-resistant Staphylococcus aureus infections or colonizations. Antimicrob Agents Chemother,1989,33:181-184.
8.	俞森洋.常见感染致病菌的耐药机制及防治对策.中国呼吸与危重监护杂志,2002,2:71-75.
9.	Du B, Chen D,Liu D,et al.Restriction of third-generation cephalosporin use decreases infection-related mortality.Crit Care Med,2003,31:1088-1093.
10.	Rice LB, Willey SH, Papanicolaou GA, et al.Outbreak of ceftazidime resistance caused by extended-spectrum beta-lactamases at a Massachusetts chronic-care facility.Antimicrob Agents Chemother,1990,34:2193-2199.
11.	Wallace MR, Johnson AP, Daniel M,et al.Sequential emergence of multi-resistant Klebsiella pneumoniae in Bahrain.J Hosp Infect,1995,31:247-252.
12.	Dzidic S, Bedekovi? V.Horizontal gene transfer-emerging multidrug resistance in hospital bacteria. Acta Pharmacol Sin,2003,24:519-26.
13.	戚其学,王春雷,李艳玲,等.169例非发酵革兰阴性杆菌所致院内获得性肺炎的危险因素及耐药性分析.中国血液流变学杂志,2007,17:290-292.

1. 王东浩,王伟,王勇强,等.重症监护病房获得性细菌感染临床调查.中华医院感染学杂志,2004,14:151-153.
2. 巩志业,温宁,王枢群.多重耐药及其控制.中国公共卫生,2002,18:1022-1023.
3. Falagas ME, Koletsi PK,Bliziotis IA.The diversity of definitions of multidrug-resistant (MDR) and pandrug-resistant (PDR) Acinetobacter baumannii and Pseudomonas aeruginosa.J Med Microbiol,2006,55:1619-1629.
4. McGowan JE Jr.Resistance in nonfermenting gram-negative bacteria: multidrug resistance to the maximum.Am J Med,2006,119:S29-S36.
5. Quinn jP.Clinical problems posed by multiresistant nonfermenting gram-negative pathogens.Clin Infect Dis,1998,27:S117-S124.
6. Tenover FC.Novel and emerging mechanisms of antimicrobial resistance in nosocomial pathogens. Am J Med,1991,91:76S-81S.
7. Smith SM,Eng RK,Tecson-Tumany F.Ciprofloxacin therapy for methicillin-resistant Staphylococcus aureus infections or colonizations. Antimicrob Agents Chemother,1989,33:181-184.
8. 俞森洋.常见感染致病菌的耐药机制及防治对策.中国呼吸与危重监护杂志,2002,2:71-75.
9. Du B, Chen D,Liu D,et al.Restriction of third-generation cephalosporin use decreases infection-related mortality.Crit Care Med,2003,31:1088-1093.
10. Rice LB, Willey SH, Papanicolaou GA, et al.Outbreak of ceftazidime resistance caused by extended-spectrum beta-lactamases at a Massachusetts chronic-care facility.Antimicrob Agents Chemother,1990,34:2193-2199.
11. Wallace MR, Johnson AP, Daniel M,et al.Sequential emergence of multi-resistant Klebsiella pneumoniae in Bahrain.J Hosp Infect,1995,31:247-252.
12. Dzidic S, Bedekovi? V.Horizontal gene transfer-emerging multidrug resistance in hospital bacteria. Acta Pharmacol Sin,2003,24:519-26.
13. 戚其学,王春雷,李艳玲,等.169例非发酵革兰阴性杆菌所致院内获得性肺炎的危险因素及耐药性分析.中国血液流变学杂志,2007,17:290-292.

Chinese Journal of Respiratory and Critical Care Medicine

Analysis on the Antibiotics Resistance and Risk Factors of Multidrug Resistant Bacteria in Respiratory Intensive Care Unit

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