Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China (mainland).
Med Sci Monit. 2018 Nov 28;24:8602-8607. doi: 10.12659/MSM.911229.
BACKGROUND Antimicrobial resistance of nosocomial pathogens has become a worldwide problem that leads to major healthcare and economic burdens. Regional antimicrobial resistance profiles are needed to inform selection of proper antimicrobial agents. MATERIAL AND METHODS In collaboration with the Hospital Infection Control Office at our hospitals, we analyzed the constitution of nosocomial pathogens and the corresponding drug-resistance profiles. We paid particular attention to characteristics of pathogens that were derived from the bloodstream, and summarized the drug-resistance tendency of 2 specific bacteria within the most recent decade to reflect the development of resistance in regional China. RESULTS The most common types of nosocomial pathogens were Escherichia coli (859 isolates, 14.3%), Staphylococcus aureus (763 isolates, 12.7%), Acinetobacter baumannii (681 isolates, 11.3%), Klebsiella pneumonia (660 isolates, 11.0%), and Pseudomonas aeruginosa (654 isolates, 10.9%). The most common types of bloodstream-derived pathogens were K. pneumoniae (125 isolates, 16.3%), E. coli (118 isolates, 15.3%), A. baumanii (81 isolates, 10.5%), Candida albians (57 isolates, 7.4%), S. aureus (45 isolates, 5.9%), P. aeruginosa (44 isolates, 5.7%), and Enterobacterium spp. (42 isolates, 5.5%). Distinct antimicrobial resistance profiles were observed between different pathogens as well as between bloodstream-derived and other sources of pathogens. The resistant rates of A. baumanii and P. aeruginosa to antimicrobial agents have been increasing during the most recent 10 years at our hospital. CONCLUSIONS Our data demonstrated the characteristics of nosocomial infections and antibiotic resistance in regional China. The distinct resistance profile of each pathogen can help to tailor individual antimicrobial strategy. The emerging resistant rates to antimicrobials require reinforced actions for infection prevention and control.
医院病原体的抗药性已成为一个全球性问题,导致了重大的医疗保健和经济负担。需要了解区域抗药性概况,以便选择适当的抗生素。
与我们医院的医院感染控制办公室合作,我们分析了医院病原体的构成和相应的耐药谱。我们特别关注来自血液的病原体的特征,并总结了最近十年中两种特定细菌的耐药趋势,以反映中国区域耐药性的发展。
最常见的医院病原体类型是大肠杆菌(859 株,14.3%)、金黄色葡萄球菌(763 株,12.7%)、鲍曼不动杆菌(681 株,11.3%)、肺炎克雷伯菌(660 株,11.0%)和铜绿假单胞菌(654 株,10.9%)。最常见的血流源病原体类型是肺炎克雷伯菌(125 株,16.3%)、大肠杆菌(118 株,15.3%)、鲍曼不动杆菌(81 株,10.5%)、白念珠菌(57 株,7.4%)、金黄色葡萄球菌(45 株,5.9%)、铜绿假单胞菌(44 株,5.7%)和肠杆菌科(42 株,5.5%)。不同病原体以及血流源和其他来源的病原体之间观察到不同的抗生素耐药谱。在我们医院,鲍曼不动杆菌和铜绿假单胞菌对抗生素的耐药率在最近 10 年中一直在增加。
我们的数据表明了中国区域医院感染和抗生素耐药的特征。每种病原体的独特耐药谱有助于制定个体化的抗生素策略。对抗生素的新兴耐药率需要加强感染预防和控制措施。