Abstract:

Objective  To investigate the distribution of pathogens and antimicrobial resistance among patients with lower respiratory tract infections managed in respiratory intensive care unit(RICU), and analyze the risk factors for multi-drug resistant pathogen infections for evidences to control and prevent the drug resistance. Methods  A total of 74 patients with lower respiratory tract infections and positive sputum cultures, undergone treatment in the RICU in Wuxi No. 2 People’s Hospital from January to December of 2014, were enrolled in the study. The distribution of pathogens inducing lower respiratory tract infections and antimicrobial resistance were investigated, and the risk factors for multi-drug resistant bacterial infections were identified and statistically analyzed. Results  A total of 161 pathogens were isolated from the 74 subjects, and the top 4 pathogens included Staphylococcus aureus (23.60%), Klebsiella pneumoniae (20.50%), Acinetobacter baumannii (16.15%) and Pseudomonas aeruginosa (9.94%). 106 strains of multi-drug resistant pathogens (65.84%) were identified, in which S. aureus (35.85%), K. pneumoniae (22.64%) and A.baumannii (14.15%) were prominent. Twelve strains of pan-drug resistant pathogens (7.45%)were associated with A. baumannii (11 strains) and K. pneumoniae (1 strain). Forty-nine of 74 patients (66.22%) were co-infected with at least two types of pathogens, in whom 31 patients (41.89%) were co-infected with methicillin-resistant S. aureus. Logistic regression analysis indicated that Acute Physiology and Chronic Health Evaluation (APACHE Ⅱ) scoring was independent risk factor of multi-drug resistant bacterial infections. Conclusion  Higher multi-drug resistant bacterial infections were observed in the patients with lower respiratory tract infections managed in RICU, and APACHE Ⅱ is an independent risk factor of multi-drug resistant bacterial infections.

Key words: Respiratory intensive care unit, Lower respiratory tract infection, Multi-drug resistance, Risk factor