Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China

Abstract

The frequency of antimicrobial resistance has increased globally due to misuse and overuse of antibiotics, and multi-drug resistant (MDR) bacteria are now recognized as a major cause of hospital-acquired infections (HAI). Our aim was to investigate the prevalence, distribution, and antimicrobial susceptibility rates of MDR bacteria in patients with HAI from a tertiary hospital in China. We retrospectively evaluated all patients with a confirmed diagnosis of bacterial infection at a tertiary general hospital in Jining, for the period between January 2012 and December 2014. The following clinical and demographic data were collected: age, sex, specimens, treatment, microbiology results, and antibiotic resistance patterns of isolates. Bacterial identification and susceptibility testing were performed using VITEK 2 COMPACT system. We screened a total of 15,588 patients, out of which 7579 (48.6%) had an HAI. MDR showed 3223 out of 7579 isolates (42.5%). The most frequently isolated MDR bacteria in patients with HAI were extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (n = 1216/3223, 37.7%), MDR Pseudomonas aeruginosa (n = 627/3223, 19.5%) and MDR Acinetobacter baumannii (n = 588/3223, 18.2%). MDR-HAI were more common in males (2074/3223, 64.4%) and in elderly patients (≥60 years; 1196/3223, 37.1%). Sputum was the main source of MDR isolates (2056/3223, 63.8%). Patients with MDR-HAI were predominantly distributed in different types of intensive care units. MDR strains in our study showed resistance to most current antibiotics. Overall, patients with HAI infections attributed to MDR bacteria were widely distributed in our hospital. Enhanced surveillance of MDR bacteria is critical for guiding the rational use of antibiotics and reducing the incidence of HAI.

Drug resistance of pathogens causing nosocomial infection in orthopedics from 2012 to 2017: a 6-year retrospective study

“…Among the most widespread bacteria worldwide, E. coli is a known cause of urinary tract and bloodstream infections [18,20]. The antibiotic-resistance patterns of E. coli in this study corresponded to those in previous reports [16,21,22]. Taken together, the findings suggest that we should reduce the usage of antibiotics to which E. coli is highly resistant, such as ampicillin.…”

“…Given that MDR bacteria are now recognized as a major cause of nosocomial infections [32], hospitals must work to control their incidence rate. Here, 43.3% and 74.2% of the strains were MRSA isolates and ESBL-positive E. coli, respectively, similar to a previous study in China [22]. The similarity suggests that some demographic and clinical characteristics could increase the risks of MDR bacterial infections.…”

“…We observed a significant link between ESBL-producing E coli infections and degenerative diseases, which mainly affect elderly patients. Previous studies have indicated that elderly patients are at high risk of nosocomial infections, especially from MDR bacteria [22,34]. This age-related risk was somewhat supported in our study, although we did not identify a significant relationship between elderly patients and MDR bacterial infections.…”

Sepsis Caused by Elizabethkingia meningoseptica Successfully Treated by Polymyxin B: A Case Report

“…The resistance rates of P. aeruginosa to ciprofloxacin, imipenem, piperacillin tazobactam, cefoperazone sulbactam, amikacin, and polymyxin B were 18.9%, 30.7%, 16.7%, 17.1%, 6.2%, and 1.2%, respectively. A. baumannii, P. aeruginosa, and K. pneumoniae are three most common pathogens in the ICU and are multi-drug resistant in many cases (19,20). The above data indicate that when EM infections are combined with infections of other bacteria, although EM is sen- shows sensitivity only to tigecycline and polymyxin B.…”

Laryngeal tuberculosis in renal transplant recipients: A case report and review of the literature

“…In these patients (Table 1), the main symptoms were hoarseness, dysphonia, odynophagia, cough and fever, and biopsy samples of tissue revealed granulomatous inflammation. The treatment of TB may be complex, and drug resistance often develops [14,15]. Standard therapeutic agents include isoniazid, rifampicin and pyrazinamide, although modifications of therapy because of cost have been reported in the literature [2]; neither of the patients were given rifampicin because it would have necessitated an increase in the cyclosporine dose and, consequently, the cost of therapy.…”