title: Differences in distribution and drug sensitivity of pathogens in lower respiratory tract infections between general wards and RICU.
abstract: BACKGROUND
  Lower respiratory tract infections (LRTIs) are common among patients in hospitals worldwide, especially in patients over the age of 60. This study investigates the differences in distribution and drug sensitivity of pathogens in LRTIs.
  
  
  METHODS
  The clinical and laboratory data of 4,762 LRTI patients in the general ward and respiratory intensive care unit (RICU) of Xiangya Hospital (Changsha) were retrospectively analyzed.
  
  
  RESULTS
  The infection rate of Gram-negative bacteria was significantly higher than that of Gram-positive bacteria in both the general ward and RICU (P<0.05). The incidence of Gram-negative bacteria infection was significantly higher in the RICU than in the general ward (P<0.05), whereas the incidence of Gram-positive bacteria infection is less in the RICU than in the general ward (P<0.05). In the general ward, the incidence of Gram-negative bacteria infection significantly increased (P<0.05) over time, whereas the incidence of Gram-positive bacteria infection significantly decreased from 1996 to 2011 (P<0.05). In the RICU, the incidence of Gram-positive bacteria infection decreased, while Gram-negative bacteria infections increased without statistical significance (P>0.05). Staphylococcus pneumoniae and Staphylococcus aureus were found to be the predominant Gram-positive strains in the general ward (34.70-41.18%) and RICU (41.66-54.87%), respectively (P>0.05). Pseudomonas aeruginosa and Acinetobacter baumannii were the predominant gram negative strains in the general ward (19.17-21.09%) and RICU (29.60-33.88%), respectively (P>0.05). Streptococcus pneumoniae is sensitive to most antibiotics with a sensitivity of more than 70%. Staphylococcus aureus is highly sensitive to vancomycin (100%), linezolid (100%), chloramphenicol (74.36-82.19%), doxycycline (69.57-77.33%), and sulfamethoprim (67.83-72.46%); however, its sensitivity to other antibiotics is low and decreased each year. Sensitivity of Pseudomonas aeruginosa to most β-lactam, aminoglycoside, and quinolone group antibiotics decreased each year.
  
  
  CONCLUSIONS
  The distribution and drug sensitivity of LRTI pathogens exhibit a high divergence between the general ward and RICU. Streptococcus pneumoniae may not be the predominant pathogen in LRTIs in some areas of China.
authors.affiliation: Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Ruoxi
authors.initials: R
authors.lastname: He
authors.affiliation: Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Bailing
authors.initials: B
authors.lastname: Luo
authors.affiliation: Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Chengping
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Ruichao
authors.initials: R
authors.lastname: Niu
keywords: Drug sensitivity; antibiotics; general ward; lower respiratory tract infections (LRTIs); respiratory intensive care unit (RICU)