Analysis of bacterial distribution and resistance from exacerbation of COPD patients in C and D Classification in our emergency department

Abstract

Objective To analyze the bacterial distribution and resistance of clinical isolates from exacerbation of COPD patients in C and D classification in our emergency department.Methods The sputums were taken to culture and antimicrobial susceptibility test.VITEK-2 compact automicrobe system was used to identify bacteria.Disc diffusion test was used to determine the antimicrobial resistance.Results Of 222 clinical isolates,27.0％ were Gram positive bacteria,73.0％ were Gram negative bacteria.The Gram positive bacteria mainly was Staphylococcus aureus and Streptococcus pneumoniae.The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) were 50.00％.The MRSA were more resistant than methicillin-sensitive Staphylococcus aureus (MSSA),and they were all sensitive to vancomycin,linezolid or tigecycline.The Gram negative bacteria mainly was Pseudomonas aeruginosa,Escherichia coli,Klebsiella spp and Acinetobacter baumannii.Pseudomonas aeruginosa and Acinetobacter baumannii had high resistant rates.The extended spectrum β-lactamases (ESBLs) producing strains in Escherichia coli were higher than in Klebsiella spp,which had multiple drug resistance.Conclusions The bacterial resistance situation is very severely in exacerbation of COPD patients in C and D classification in our emergency department.The first isolating rate was Pseudomonas aeruginosa.Surveillance of bacterial resistance is very important and effective control measures to reduce resistance is very necessary. Key words: Bacterial resistance; Antimicrobial agent; Chronic obstructive pulmonary disease; Bacterial distribution; Emergency department; Exacerbation; Surveillance of bacterial resistance; Reduce resistance