Department of Infectious Diseases, Apollo Hospital, Chennai, India.
SRL Fortis Hospital Mulund, Mumbai, India.
J Glob Antimicrob Resist. 2020 Sep;22:457-461. doi: 10.1016/j.jgar.2020.02.030. Epub 2020 Mar 9.
The prevalence of drug-resistant cases is increasing globally. The present study aimed to investigate the prevalence of cases of blood culture positive for multidrug-resistant Gram-negative bacteria (MDR-GNB) at the time of admission, i.e. within 24h of admission to hospital from primary or secondary care centres.
This record-based retrospective cross-sectional study was designed to analyze MDR-GNB-positive cases at Fortis Hospital, Mumbai, India. Fortis Hospital is a 500-bed referral tertiary care centre. An increase of MDR-GNB was seen from January 2012 to June 2014 in the hospital. A retrospective analysis of blood culture GNB-positive samples was performed to evaluate MDR-GNB-positive cases at admission.
The total number of positive blood cultures in January to December 2012, January to December 2013 and January to June 2014 were 221, 236 and 116, respectively, with 77.83%, 79.66% and 69.83% GNB-positive. Total MDR-GNB-positive cases were 26.16%, 32.98% and 33.33%, respectively, and amongst these MDR-GNB, 22%, 32% and 37% where positive at time of admission to the hospital. The MDR-GNB were Escherichia coli, Klebsiella, Acinetobacter, Pseudomonas and Enterobacter.
MDR-GNB blood cultures positive at admission rose from January 2012 to June 2014 and hence there is an urgent need for possible contact isolation of all patients coming from primary and secondary to tertiary health care centres which should be made compulsory until screening rules out MDR-GNB to prevent spread of MDR organisms in the hospital.
全球范围内耐药病例的患病率正在上升。本研究旨在调查初级或二级保健中心入院后 24 小时内即入院时血培养多重耐药革兰氏阴性菌（MDR-GNB）阳性病例的患病率。
本回顾性基于记录的横断面研究旨在分析印度孟买 Fortis 医院的 MDR-GNB 阳性病例。Fortis 医院是一家拥有 500 张床位的转诊三级保健中心。医院在 2012 年 1 月至 2014 年 6 月期间观察到 MDR-GNB 增加。对血培养 GNB 阳性样本进行回顾性分析，以评估入院时的 MDR-GNB 阳性病例。
2012 年 1 月至 12 月、2013 年 1 月至 12 月和 2014 年 1 月至 6 月的阳性血培养总数分别为 221、236 和 116，其中 GNB 阳性率分别为 77.83%、79.66%和 69.83%。总 MDR-GNB 阳性病例分别为 26.16%、32.98%和 33.33%，其中 MDR-GNB 在入院时呈阳性的比例分别为 22%、32%和 37%。MDR-GNB 包括大肠杆菌、克雷伯菌、不动杆菌、铜绿假单胞菌和肠杆菌。
入院时 MDR-GNB 血培养阳性率从 2012 年 1 月上升至 2014 年 6 月，因此迫切需要对所有从初级和二级保健中心转至三级保健中心的患者进行可能的接触隔离，直至筛查排除 MDR-GNB 为止，以防止 MDR 病原体在医院内传播。
