Clinical distribution and antibiotic resistance analysis of multidrug-resistant organism infections in a non-intensive care unit of a hospital from 2020 to 2023
10.3760/cma.j.cn341190-20240808-01017
- VernacularTitle:2020—2023年某院非重症监护病房多重耐药菌感染临床分布及耐药性分析
- Author:
Fengying DU
1
;
Yifan LIU
Author Information
1. 江苏省人民医院宿迁医院 宿迁市第一人民医院感染管理处，宿迁 223800
- Publication Type:Journal Article
- Keywords:
Bacteria;
Drug resistance, multiple;
Cross infection;
Infection control;
Microbial sensitivity tests;
Methicillin-resistant staphylococcus aureus;
Pseudomon
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(3):364-370
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical distribution and antibiotic resistance of multidrug-resistant organism (MDRO) infections in the non-intensive care unit (ICU) of Jiangsu Provincial (Suqian) Hospital (Suqian First Hospital), providing a basis for effective implementation of infection prevention and control measures.Methods:Using the real-time monitoring system for hospital infections, this study selected 520 strains of MDROs isolated from non-ICU hospitalized patients at Jiangsu Provincial (Suqian) Hospital (Suqian First Hospital) from January 2020 to December 2023 for analysis. Based on their origin, these strains were categorized into two groups: hospital-acquired infections and community-acquired infections. The clinical distribution characteristics of MDRO infections and their resistance rates to commonly used antimicrobial agents were analyzed.Results:The average detection rate of MDRO in non-ICU over 4 consecutive years was 13.60% (782/5 750). The detection rates for methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and carbapenem-resistant Enterobacteriaceae were 46.49% (424/912), 43.81% (85/194), 18.61% (177/951), and 2.60% (96/3 693), respectively. The predominant MDROs identified were MRSA (54.23%, 282/520) and CRPA (28.65%, 149/520). Hospital-acquired infections accounted for 13.65% (71/520), while community-acquired infections comprised 86.35% (449/520). The three departments with the highest infection rates were the Department of Respiratory (22.31%), the Department of Pediatrics (15.19%), and the Department of Traditional Chinese Medicine and Burn (7.88%). All of these departments were primarily associated with community-acquired infections. Statistically significant differences were observed in the composition of MDRO infections among different departments ( P < 0.05). The largest proportion of specimens was obtained from sputum (59.81%), followed by wound secretions (20.77%). Sputum samples exhibited a higher proportion in community-acquired infections compared to hospital-acquired infections (63.25% vs. 38.03%, χ2 = 16.23, P < 0.05). The lower respiratory tract was identified as the primary site for community-acquired infections. Antimicrobial susceptibility testing revealed that CRAB was 100% resistant to penicillins, carbapenems, and most cephalosporins. CRPA demonstrated 100% resistance to penicillins and trimethoprim-sulfamethoxazole, but showed lower resistance rates for other antibiotics compared to CRAB and carbapenem-resistant Klebsiella pneumoniae. MRSA was 100% resistant to penicillin and cefoxitin, but exhibited a resistance rate of 0% to tigecycline and linezolid. Conclusions:In our hospital, 86.35% of MDRO infections in non-ICU departments originated from the community, primarily involving MRSA and CRPA. There were significant differences in the proportion of MDRO infections across different departments, and resistance to carbapenem antibiotics was serious. Infection prevention and control departments should implement targeted prevention strategies based on these distribution characteristics.
