Species Distribution and Antibiotic Resistance of Pathogens from Bloodstream Infections in Intensive Care Unit_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LUO Yunshan , WAN Xianyao.

Intensive Care Unit, First Affiliated Hospital of Dalian Medical University. Dalian, Liaoning,116011, ChinaCorresponding Author: WAN Xian-yao, E-mail: wanxianya@ gmail. com;

Corresponding author：

Keywords：

血流感染; 细菌培养; 细菌耐药; 重症加强治疗病房

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Objective To investigate the species distribution and antibiotic resistance among the bloodstream infections in intensive care unit ( ICU) . Methods A retrospective analysis was performed to review the microbiological and susceptibility test data of all bloodstream infections in ICU from January 2004 to September 2009. The patterns of antibiotic resistance among the top five bacteria were compared. Results 89 cases of bloodstream infection were detected with 112 strains, including 55 Gram-positive ( G+ ) bacteria( 49. 1% ) , 55 Gram-negative ( G- ) bacteria ( 49. 1% ) , and 2 fungi ( 1. 8% ) . The main pathogens causing bloodstream infection were Burkholderia spp. ( 33, 29. 5% ) , S. epidermidis( 31, 27. 7% ) , Klebsiella pneumoniae ( 7, 6. 3% ) , S. aureus ( 7, 6. 3% ) , S. hominis ( 6, 5. 4% ) , Acinetobacter baumannii ( 6,5. 4% ) , Pseudomonas aeruginosa( 5, 4. 5% ) and S. haemolyticus( 5, 4. 5%) , suggesting that Burkholderia spp. was predominant pathogenic G- bacteria, and coagulase-negative staphylococcus was predominant G+ bacteria. The antibiotic resistance tests demonstrated that isolated G- bacillus was highly sensitive to carbopenem, while vancomycin-resistant G+ cocci were not found. Conclusions Within the latest 5 years,the prevalence of G+ bacteria infection is almost equivalent to G- bacteria in blood stream infection.Coagulase-negative staphylococcus is the mainly G+ bacteria and Burkholderia spp. is predominant in G- bacteria. Carbopenemand glycopeptides still remain to be the first choice.

Citation： LUO Yunshan,WAN Xianyao.. Species Distribution and Antibiotic Resistance of Pathogens from Bloodstream Infections in Intensive Care Unit. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(5): 493-497. doi: Copy

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1. Warren DK, Zack JE, Elward AM, et al. Nosocomial primary bloodstream infections in intensive care unit patients in a nonteaching community medical center: a 21-month prospective study. Clin Infect Dis, 2001, 33: 1329-1335.
2. Wisplinghoff H, Bischoff T, Tallent SM, et al. Nosocomial bloodstream infections in US hospitals: analysis of 24 179 cases from a prospective nationwide surveillance study. Clin Infect Dis,2004, 39: 309-317.
3. Mylotte JM, Tayara A, Goodnough S. Epidemiology of bloodstream infection in nursing home residents: evaluation in a large cohort from multiple homes. Clin Infect Dis, 2002, 35: 1484 -1490 .
4. Lepper PM, Grusa E, Reichl H, et al. Consumption of imipenem correlates with bete-lactam resistance in Pseudomonas aeruginosa.Antimicrob Agents Chemother, 2002, 46: 2920-2925 .
5. 万献尧. Sepsis 诊治进展. 医师进修杂志( 内科版) , 2005, 28( 8A) : 51-54.
6. Diekema DJ, Pfaller MA, Jones RN, et al. Age-related trends in pathogen frequency and antimicrobial susceptibility of bloodstream isolates in North America. SENTRY Antimicrobial Surveillance Program, 1997-2000. Int J Antimicrob Agents, 2002 , 20: 412-418.
7. Lakshmi KS, Jayashree M, Singhi S, et al. Study of nosocomial primary bloodstream infections in a pediatric intensive care unit. J Trop Pediatr, 2007, 53: 87-92.
8. Wisplinghoff H, Seifert H, Tallent SM, et al. Nosocomial bloodstream infections in pediatric patients in United States hospitals: epidemiology, clinical features and susceptibilities.Pediatr Infect Dis J, 2003, 22: 686-691 .
9. Moubareck C, Meziane-Cherif D, Courvalin P, et al. VanA-type Staphylococcus aureus strain VRSA-7 is partially dependent on vancomycin for growth. Antimicrob Agents Chemother, 2009, 53 :3657-3663.
10. 黄翠雯, 周晓光, 黄嘉言. 新生儿败血症病原菌及其药物敏感试验分析. 中华医院感染学杂志, 2005, 15: 1071-1073.
11. 黄伟, 教鸣, 王晶, 等. 重症监护病房中产超广谱β-内酰胺酶革兰阴性细菌致院内感染的临床调查. 中国呼吸与危重监护杂志, 2003, 2: 291 -293.
12. Grik K, Dierich MP, Pfaller K, et al. In vitro activity of fosfomycin in combination with various antistaphylococcal substances. J Antimicrob Chemother, 2001, 48: 209-217 .
13. Iskandar SB, Guha B, Krishnaswamy G, et al. Acinetobacter baumannii pneumonia: a case report and review of the literature.Tenn Med, 2003, 96: 419-422 .

Chinese Journal of Respiratory and Critical Care Medicine

Species Distribution and Antibiotic Resistance of Pathogens from Bloodstream Infections in Intensive Care Unit

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