Etiological analysis of 216 cases of hospital-acquired infections in neurology intensive care unit

Objective To investigate microbiological etiology of hospital-acquired infections in Neurology ICU and their antibiotic resistance pattern to provide basis for rational antimicrobial therapy.Methods The pathogens of hospital-acquired infections in 216 NICU patients and the results of susceptibility testing from January 1,2008 to December 31,2011 were analyzed retrospectively.Results The top three infections were pneumonia(including 39 ventilator-associated pneumonia),urinary tract infection(including 91 catheter-associated urinary tract infections),and bloodstream infection(including 11 central venous catheter-related bloodstream infections).A total of 582 strains of pathogens were collected,of which gram negative bacilli,gram positive cocci and fungal pathogens accounted for 65.5%,24.9% and 9.6%,respectively.The top five gram-negative rods were Klebsiella pneumoniae(25.2%),Pseudomonas aeruginosa(22.3%),Acinetobacter baumannii(18.1%),Escherichia coli(17.3%) and Proteus mirabilis(4.5%).The top gram-positive pathogens were Staphylococcus aureus(43.4%),Staphylococcus haemolyticus(17.2%),Enterococcus faeciumv(8.3%),Staphylococcus epidermidis(8.3%),and Enterococcus gallinarum(4.8%).Candida albicans was the most frequently reported fungal pathogen.Most strains of gram negative rods were highly susceptible to carbapenems,cefoperazone-sulbactam and piperacillin-tazobactam,but resistant to aminoglycosides and fluoroquinolones.The resistance of Acinetobacter baumannii was serious,including 29%(20/69) extensively drug-resistant strains.The strains of Acinetobacter baumannii were highly susceptible to only cefoperazone-sulbactam.Strains of gram positive cocci were highly susceptible to vancomycin and linezolid.Conclusions Most of the hospital infections in NICU are device-related infections,including ventilator-associated pneumonia,catheter-associated urinary tract infections,and central venous catheter-related bloodstream infections.Non-fermentative gram-negative bacilli are the top-ranking pathogens.Most A.baumannii strains are multi-drug resistant.