Comparison of distribution and drug resistance of bacteria in sputum culture in different ICU wards of same hospital

Objective To compare the distribution and drug resistance of bacteria detected in sputum culture in different ICU wards in our hospital,and provide evidence for clinical infection treatment and drug resistance monitoring. Methods The patients from different ICU wards in our hospital were divided into 3 groups,the first group consisted of the patients in neurology department,the second group consisted of the patients in internal medicine department and the third group consisted of the patients in emergency room of internal medicine. The distribution and drug resistance of bacteria detected in sputum culture of the patients in 3 groups were analyzed retrospectively. Results A total of 30 kinds of pathogens were isolated in the first group, 39 kinds of pathogens in the second group and 23 kinds of pathogens in the third group. The pathogens were mainly gram negative bacilli,the first 3 pathogens were Pseudomonas aeruginosa,Klebsiella pneumoniae and Acinetobacter baumannii. Drug susceptibility test showed that the differences in overall drug resistance rate of P. aeruginosa to amoxicillin/clavulanic acid, aztreonam,cefepime,ceftazidime,tigecycline,piperacillin/tazobactam and piperacillin were significant among three groups (P<0.05),and the resistant rates to imipenem and meropenem were higher in the second group than those in other two groups, the differences were significant (P=0.001). The differences in overall drug resistance of K. pneumoniae to aztreonam, cefoperazone/sulbactam,imipenem and ceftazidime were significant among three groups. The differences in overall drug resistance of A. baumannii.to amikacin,cotrimoxazole,tigecycline and tobramycin were not significant among three groups,but the differences in drug resistance to other antibiotics were significant in each group(P<0.05). Conclusion Pseudomonas aeruginosa, and A. baumannii detected in different ICU wards were multi drug resistant, the drug resistant rate of K. pneumoniae was lower,but some K. pneumoniae strains were multi-drug resistant or all drug resistant. It is necessary to pay attention to sputum culture and drug resistance monitoring,conduct targeted treatment instead of empirical treatment for the accurate treatment of infection.