Analysis of the Distribution and Antibiotic Resistance of Pathogens Causing Infections in Hospitals from 2017 to 2019.

BACKGROUND

Antibiotic resistance is a global public health problem, leading to high mortality and treatment costs. To achieve more efficient treatment protocols and better patient recovery, the distribution and drug resistance of pathogens in our hospital were investigated, allowing significant clinical guidance for the use of antimicrobials.

METHODS

In this retrospective study (2017-2019), 3482 positive samples were isolated from 43,981 specimens in 2017; 3750 positive specimens were isolated from 42,923 specimens in 2018; and 3839 positive pathogens were isolated from 46,341 specimens in 2019. These samples were from various parts of the patients, including the respiratory tract, urine, blood, wound secretions, bile, and puncture fluids. The distribution and antibiotic resistance of these isolated pathogens from the whole hospital were analyzed.

RESULTS

The results from pathogen isolation showed that (12.8%), (11%), (10.8%), (10.7%), and (6.4%) represented the five main pathogenic bacteria in our hospital. (16.2% and 17.5%) occupied the largest proportion in the central intensive care unit (central ICU) and respiratory intensive care unit (RICU), while (15.4%) was the most common pathogen in the emergency intensive care unit (EICU). The resistance rate of to trimethoprim and minocycline was 100%, and the sensitivity rate to ertapenem, furantoin, and amikacin was above 90%. The resistance rate of to all antibiotics, such as piperacillin and ciprofloxacin, was under 40%. The sensitivity rate of to tigecycline and minocycline was less than 30%, and the resistance rate to many drugs such as piperacillin, ceftazidime, and imipenem was above 60%. Extended-spectrum -lactamases (ESBLs)-producing (ESBLs-KPN) and carbapenem-resistant (CRE-KPN), ESBLs-producing (ESBLs-ECO) and carbapenem-resistant (CRE-ECO), multidrug-resistant (MDR-AB), multidrug-resistant (MDR-PAE), and methicillin-resistant (MRSA) are all important multidrug-resistant bacteria found in our hospital. The resistance rate of ESBLs-producing to ceftriaxone and amcarcillin-sulbactam was above 95%. CRE bacteria showed the highest resistance to amcarcillin-sulbactam (97.1%), and the resistance rates of MDR-AB to cefotaxime, cefepime, and aztreonam were 100%. The resistance rates of MDR-PAE to ceftazidime, imipenem, and levofloxacin were 100%, and the sensitivity rate to polymyxin B was above 98%. The resistance rate of MRSA to oxacillin was 100%, and the sensitivity rate to linezolid and vancomycin was 100%.

CONCLUSION

The distribution of pathogenic bacteria in different hospital departments and sample sources was markedly different. Therefore, targeted prevention and control of key pathogenic bacteria in different hospital departments is necessary, and understanding both drug resistance and multiple drug resistance of the main pathogenic bacteria may provide guidance for the rational use of antibiotics in the clinic.