Distribution and drug resistance of bacteria in 205 adult septicemia patients

Objective To investigate the distribution and antimicrobial resistance of pathogens in adult patients with septicemia.Methods The pathogens isolated from blood specimens and antimicrobial susceptibility tests in 205 adult patients with septicemia from January 2003 to June 2007 in our hospital were analyzed retrospectively.Results A total of 221 strains were isolated from 205 patients.Gram-negative bacteria,Gram-positive bacteria and fungus accounted for 63.8%(141/221),29.9%(66/221),6.3%(14/221)respectively.The top three pathogens were Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa in Gram-negative bacteria while coagulase negative Staphylococcus,Staphylococcus aureus and enterococcus in Gram-positive bacteria.Extended-spectrum β-lactamases(ESBLs)producing strains were detected in 20.0%(8/40)of Escherichia coliand 61.5%(24/39)of Klebsiella pneumoniae.Methicillin resistant strains were detected in 18.2%(35/41)of Staphylococcus aureus(MRSA)and 85.4%(2/11)of coagulase negative Staphylococcus(MRCNS).Antimicrobial susceptibility tests indicated that Gram-negative bacteria were most sensitive to imepenem and Gram-positive bacteria to vancomycin.Conclusion Multiple drug resistant strains isolated from the adult patients with septicemia are common.It is necessary to monitor dynamically the distribution of pathogens and antimicrobial resistance.In clinic,antimicrobial agents for the treatment of septicemia should be chosen reasonably based on the results of bacteria culture and antimicrobial susceptibility tests,and carbapenems and glycopeptide antibiotics should be avoided to abuse.