Study on distribution of pathogens of nosocomial infection and drug resistance in critically ill patients after neurosurgical operation

Objective s To investigate the distribution characteristics of pathogenic bacteria of nosocomial infection and the drug resistance of common pathogenic bacteria in critically ill patients in neurosurgery and to provide the basis for prevention of infection and empirical antimicrobial therapy in critically ill patients in neurosurgery. Methods From January 2009 to June 2015, the clinical data of critically ill patients who admitted to the Intensive Care Unit, Beijing Tiantan Hospital, Capital Medical University after neurosurgery were analyzed retrospectively. The types of bacterial isolates and drug resistance were summarized. Results A total of 4 148 bacterial strains were isolated, including Gram-negative bacteria 3 184 strains(76.8%), Gram- positive bacteria 964 strains(23.2%). The proportion of top 6 strains as follows: Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae, Steotrophomonas maltophilia, and Escherichia coli. The sources of strains: sputum samples accounted for 84.2%, cerebrospinal fluid accounted for 4%, and others accounted for 11.8%. The resistance rates of Pseudomonas aeruginosa and Acinetobacter Bauman to a variety of antimicrobial agents were high. The resistant rates of Staphylococcus aureus to vancomycin, linezolid, teicoplanin, fusidic acid were <10%. Conclusions The bacterial infection is mainly the pulmonary infection in critically ill patients in neurosurgery, followed by intracranial infection. Gram-negative bacteria are the main pathogenic bacteria, and their drug resistance is also higher. Key words: Cross infection; Neurosurgical procedures; Gram-negative bacteria; Drug resistance, bacterial