[Change in distribution of pathogens and nosocomial antibiotic resistant Gram-negative Bacilli infection in intensive care units one month after an earthquake].
OBJECTIVE
To investigate the change in distribution of pathogens and nosocomial antibiotic resistant Gram-negative Bacilli infection in intensive care units one month after an earthquake.


METHODS
A retrospective survey on the distribution of nosocomial Gram-negative bacilli infection in intensive care units before and one month after the Wenchuan Earthquake was conducted in the West China Hospital. MicroScan Walkaway 96SI or PHOENIX 100 Automatic System in combined with manual identification, was employed to identify the Gram-negative bacilli infection and antibiotic resistance.


RESULTS
The proportion of wound infection increased from 7.9% to 20.2% one month after the earthquake, but infection in respiratory tract stayed the most common infection. The common pathogens included Acinetobacter spp. (36.2%), Pseudomonas aeruginosa (22.7%), and Klebsiella spp. (12.3%) before the earthquake. One month after the earthquake, Imipenem remained highly sensitive against Escherichia coli and Klebsiella. spp., while their resistance to ceftazidime increased. Amikacin became the most sensitive antibiotics against Pseudomonas aeruginosa. Acinetobacter spp. had increased resistance to imipenem, but was highly sensitive to gatifloxacin and cefoxitin. The prevalence of extended spectrum beta-lactamases (ESBLs) in Klebsiella spp. and Escherichia coli increased from 52.6% and 48.8% before the earthquake to 55.0% and 87.5% one month after the earthquake, respectively.


CONCLUSIONS
There is a significant change in distribution of pathogens and nosocomial antibiotic resistant Gram-negative Bacilli infection in intensive care units one month after the Earthquake, which might be associated with a sudden increase in injured patients. It is essential to regularly monitor the resistant rate of bacilli to antibiotics.
Kong
Qing-quan
QQ
Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Tu
Chong-qi
CQ
Pei
Fu-xing
FX
Huang
Fu-guo
FG
Liu
Hao
H
Song
Yue-ming
YM
Yang
Tian-fu
TF
Kang
Yan
Y
Wang
Guang-lin
GL
Liu
Li-min
LM
Fang
Yue
Y
Zhang
Hui
H
D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004190:Disasters; D024881:Drug Resistance, Bacterial; D055866:Earthquakes; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D012189:Retrospective Studies