Microbial Predominance and Antimicrobial Resistance in a Tertiary Hospital in Northwest China: A Six-Year Retrospective Study of Outpatients and Patients Visiting the Emergency Department

Abstract

Background. With the wide use of antibiotics, antimicrobial resistance becomes a serious issue. Timely understanding of microbial pathogen profiles and the change of antimicrobial resistance provide an important guidance for effective and optimized use of antibiotics in local healthcare systems. The aim was to investigate the characteristics of microbial species and their antimicrobial resistances in a tertiary hospital with an Emergency Department and outpatient clinics for a period of six years. Methodology. A retrospective study was conducted using the HIS database of a tertiary hospital between 2013 and 2018. Antimicrobial susceptibility was tested by automated systems and/or the Kirby–Bauer disc diffusion method. The data were analyzed using the WHONET 5.6 software. The Cochran-Armitage test was used to study the trends over the period of research. Results. In a total of 19,028 specimens submitted for microbial tests during the period from 49 units of the hospital, only the samples from the Emergency Department and Kidney Transplantation Clinic showed an annually significant increase ( P < 0.001 ). More than 200 species with 46.4% gram-positive cocci and 45.3% gram-negative bacilli were identified in the 3,849 nonrepetitive isolates. The methicillin-resistant S. aureus and S. epidermidis rates were 25.1% and 74.6%, respectively. 60.9% E. coli and 33.5% K. pneumonia samples carried extended-spectrum-β-lactamase. All Staphylococci and Enterococci samples were not resistant to linezolid, vancomycin, and tigecycline. In addition, only 0.01% E. coli, 1.1% K. pneumonia, and 18.7% P. aeruginosa isolates showed resistance to carbapenems. Conclusions. Vancomycin, linezolid and tigecycline were the most effective antibiotics for outpatients with gram-positive infection. Carbapenems were the most effective antibiotics for gram-negative infection. There was no significant annual increase of common multidrug resistances.

Bacterial Predominance and Antimicrobial Susceptibility Patterns of Blood Culture at a Tertiary Care Hospital, Bangladesh

“…According to antimicrobial susceptibility pattern to different antibiotics, Escherichia Coli was showed highly sensitive to imipenum, amikacin, linezolid, gentamicin (100.0%) and low sensitive to amoxycillin, ciprofloxacin, tetracycline, cefotaxime, cefuroxime (33.3%). The most sensitive drugs for Gram negative bacteria were imipenum, gentamicin 23 and low sensitive to quinolones, penicillins, and cephalosporins 12 . This finding is an indication of the irrational use of new and strong antibiotics for simple infectious or even viral diseases that leads to widespread bacterial resistance to these antibiotics.…”

Comparison of Bacterial Etiology with Antibiogram of Blood Stream Infection between Adult and Paediatric Group at a Tertiary Care Hospital in Bangladesh

“…According to antimicrobial susceptibility pattern to different antibiotics, Escherichia Coli was showed highly sensitive to imipenum, amikacin, linezolid, gentamicin 3(100%) and low sensitive to amoxycillin, ciprofloxacin, tetracycline, cefotaxime, cefuroxime 1(33.3%). The most sensitive drugs for Gram negative bacteria were imipenum, gentamicin 19 and low sensitive to quinolones, penicillins, and cephalosporins 13 . In adult group the most predominant isolated bacteria was Streptococci which showed high sensitive to imipenem, linezolid, gentamicin 4 (80%) and subsequent sensitive to ciprofloxacin, tetracycline, cefotaxime, cefuroxime 3 (60%).…”