Analysis of antimicrobial resistance in clinical isolates in a general teaching hospital in 2019_West China Medical Journal

Authors：

LI Fang , LI Wen , YUAN Jing , WANG Jing , LIU Zhe ,  ZENG Xiaoyan

Department of Clinical Laboratory, the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, P. R. China;

Corresponding?author：

ZENG Xiaoyan, Email: xiaoyanzeng@mail.xjtu.edu.cn

Keywords：

Pathogenic bacteria; Antimicrobial resistance; Antibacterial drugs

DOI：

10.7507/1002-0179.202007115

Video：

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Objective To investigate the distribution and antimicrobial resistance of the clinical strains isolated from the First Affiliated Hospital of Xi’an Jiaotong University in 2019 and provide a basis for clinical rational use of antibiotics.Methods All the clinical samples which were collected from January 1st to December 31st in 2019 were employed to determine antimicrobial resistance retrospectively. Results were interpreted according to Clinical and Laboratory Standards Institute 2019 breakpoints and analyzed by WHONET 5.6 software.Results A total of 6 784 nonduplicate strains were isolated in 2019, including 2 865 (42.2%) strains of Gram-positive bacteria and 3 919 (57.8%) strains of Gram-negative bacteria. The top five pathogens with the highest detection rate were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Pseudomonas aeruginosa, and Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus accounted for 33.0% and 72.0%, respectively. The detection rate of vancomycin-resistant Enterococcus faecium was 1.0% and the detection rates of linezolid-resistant Enterococcus faecium and Enterococcus faecalis were 0.3% and 2.9%, respectively. As for the non-meningitis Streptococcus pneumoniae, the prevalence of penicillin-susceptible Streptococcus pneumoniae was 100% in the isolates from adults. Extended-spectrum β-lactamases-producing strains accounted for 58.2%, 33.6%, and 33.3% in Escherichia coli, Klebsiella spp., and Proteus mirabilis, respectively. The total detection rate of carbapenem-resistant Enterobacteriaceae was 7.8%, among which the detection rates of carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae were 1.5% and 17.2%, respectively. The percentages of Pseudomonas aeruginosa strains resistant to imipenem and meropenem were 25.0% and 21.6%, respectively, and those of Acinetobacter baumannii were 73.8% and 74.2%, respectively.Conclusions Bacterial resistance is still serious in this hospital. It is necessary to strengthen rational drug use. At the same time, effective prevention and control measures should be taken to avoid cross-infection.

Citation： LI Fang, LI Wen, YUAN Jing, WANG Jing, LIU Zhe, ZENG Xiaoyan. Analysis of antimicrobial resistance in clinical isolates in a general teaching hospital in 2019. West China Medical Journal, 2020, 35(8): 905-911. doi: 10.7507/1002-0179.202007115 Copy

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1. 陳國建, 楊潔, 鄧艾, 等. 某綜合醫院常見多重耐藥菌感染危險因素 logistic 回歸分析. 華西醫學, 2020, 35(3): 290-295.
2. Frieri M, Kumar K, Boutin A. Antibiotic resistance. J Infect Public Health, 2017, 10(4): 369-378.
3. Fussen R, Lemmen S. Prevention of transmission of multidrug resistant bacteria. Internist (Berl), 2015, 56(11): 1246-1254.
4. Bassetti M, De Waele JJ, Eggimann P, <italic>et al</italic>. Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria. Intensive Care Med, 2015, 41(5): 776-795.
5. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. CLSI supplement M100. 29th ed. Wayne, PA: Clinical and Laboratory Standards Institute, 2019.
6. 胡付品, 郭燕, 朱德妹, 等. 2017 年 CHINET 中國細菌耐藥性監測. 中國感染與化療雜志, 2018, 18(3): 241-251.
7. 胡付品, 郭燕, 朱德妹, 等. 2018 年 CHINET 中國細菌耐藥性監測. 中國感染與化療雜志, 2020, 20(1): 1-10.
8. 黃勛, 鄧子德, 倪語星, 等. 多重耐藥菌醫院感染預防與控制中國專家共識. 中國感染控制雜志, 2015, 14(1): 1-9.
9. 蒲彰雅, 余治健, 陳重, 等. 利奈唑胺耐藥糞腸球菌感染患者臨床分離株與定植株同源性分析. 中國感染控制雜志, 2017, 16(4): 343-345, 350.
10. Bai B, Hu K, Zeng J, <italic>et al</italic>. Linezolid consumption facilitatesthe development of linezolid resistance in <italic>Enterococcus faecalis</italic> in a tertiary-care hospital: a 5-year surveillance study. Microb Drug Resist, 2019, 25(6): 791-798.
11. 馬孝煜, 蒲彰雅, 姚偉明, 等. 耐利奈唑胺糞腸球菌感染的危險因素分析. 微生物與感染, 2017, 12(4): 217-221.
12. Hu FP, Guo Y, Zhu DM, <italic>et al</italic>. Resistance trends among clinical isolates in China reported from CHINET surveillance of bacterial resistance, 2005-2014. Clin Microbiol Infect, 2016, 22(Suppl 1): S9-14.
13. Gomez-Simmonds A, Stump S, Giddins MJ, <italic>et al</italic>. Clonal background, resistance gene profile, and porin gene mutations modulate <italic>in vitro</italic> susceptibility to imipenem-relebactam in diverse Enterobacteriaceae. Antimicrob Agents Chemother, 2018, 62(8): e00573-18.
14. 徐鵑鵑, 葛瑛. 碳青霉烯類耐藥腸桿菌科細菌感染治療研究進展. 中國感染與化療雜志, 2019, 19(6): 680-686.
15. Lee CR, Lee JH, Park M, <italic>et al</italic>. Biology of <italic>Acinetobacter baumannii</italic>: pathogenesis, antibiotic resistance mechanisms, and prospective treatment options. Front Cell Infect Microbiol, 2017, 7: 55.
16. Malhotra S, Limoli DH, English AE, <italic>et al</italic>. Mixed communities of mucoid and nonmucoid <italic>Pseudomonas aeruginosa</italic> exhibit enhanced resistance to host antimicrobials. mBio, 2018, 9(2): e00275-18.

West China Medical Journal

Analysis of antimicrobial resistance in clinical isolates in a general teaching hospital in 2019

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