Analysis on pathogenic microorganism and drug-resistance of ventilator associated pneumonia in ICU

Objective To investigate the pathogenic distribution and drug resistance characteristics of ventilator associated pneumonia(VAP) in ICU. Methods The medical record datawere retrospectively collected inpatients withinvasive mechanical ventilation who diagnosed VAP in the ICU of our hospital from October,2014 to October,2015. Results A total of 47 patients were enrolled includingmale 31,female 16,age 14 to 74 years old,42 cases with intubation,26 cases with tracheostomy,Sixty-six cases of positive secretion culture,53 cases with application of antimicrobial agents before culture.66 case of VAP were diagnosed. Ninety bacterial strains isolates,which included 58(64. 4%) of gram negative bacilli,23(25. 6%) of gram positive bacteria,and 11(12. 2%) of fungus. The top five pathogenic bacteria were Paumanii(16 strains,17. 8%),Pseudomonas aeruginosa(13 strains,14. 4%),Staphylococcus aureus(11 strains,12. 2%),Klebsiella pneumoniae(9 strains,10%) and Escherichia coli(8 strains,8. 9%). The drug-resistant of Paumanii was the most serious. It has a high drug-resistant rate for Cephalosporins(100. 0%),Ampicillin/sulbactam(93. 8%),Quinolones(93. 8%). The rate of resistance to Cefoperazone/Sulbactam was minimum(48. 3%). The resistance of Pseudomonas aeruginosa to Penicillins(92. 3%) was the highest,to Ceftazidime also reach 53. 8%,to Amikacin(23. 1%) was the lowest. The resistance of Klebsiella pneumoniae to Gentamicin(100. 0%) was the highest,to Imipenem(11. 1%) was the lowest. The resistance of Escherichia coli to Ampicillin(100. 0%),Gentamicin(100. 0%) and Chemitrim(100. 0%) was the highest,to Imipenem(12. 5%) was the lowest. Methicllin-resistant strains in S. aureus(MRSA) accounted for54. 5%(6/11). No staphylococcal strains were found resistant to Vancomycin or linezolid. Conclusion VAP in ICU was mainly caused bygram negative bacilli,and multidrug-resistantare most common.