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：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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

1.	陈国建, 杨洁, 邓艾, 等. 某综合医院常见多重耐药菌感染危险因素 logistic 回归分析. 华西医学, 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 中国细菌耐药性监测. 中国感染与化疗杂志, 2018, 18(3): 241-251.
7.	胡付品, 郭燕, 朱德妹, 等. 2018 年 CHINET 中国细菌耐药性监测. 中国感染与化疗杂志, 2020, 20(1): 1-10.
8.	黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识. 中国感染控制杂志, 2015, 14(1): 1-9.
9.	蒲彰雅, 余治健, 陈重, 等. 利奈唑胺耐药粪肠球菌感染患者临床分离株与定植株同源性分析. 中国感染控制杂志, 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.	马孝煜, 蒲彰雅, 姚伟明, 等. 耐利奈唑胺粪肠球菌感染的危险因素分析. 微生物与感染, 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.	徐鹃鹃, 葛瑛. 碳青霉烯类耐药肠杆菌科细菌感染治疗研究进展. 中国感染与化疗杂志, 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.

1. 陈国建, 杨洁, 邓艾, 等. 某综合医院常见多重耐药菌感染危险因素 logistic 回归分析. 华西医学, 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 中国细菌耐药性监测. 中国感染与化疗杂志, 2018, 18(3): 241-251.
7. 胡付品, 郭燕, 朱德妹, 等. 2018 年 CHINET 中国细菌耐药性监测. 中国感染与化疗杂志, 2020, 20(1): 1-10.
8. 黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识. 中国感染控制杂志, 2015, 14(1): 1-9.
9. 蒲彰雅, 余治健, 陈重, 等. 利奈唑胺耐药粪肠球菌感染患者临床分离株与定植株同源性分析. 中国感染控制杂志, 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. 马孝煜, 蒲彰雅, 姚伟明, 等. 耐利奈唑胺粪肠球菌感染的危险因素分析. 微生物与感染, 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. 徐鹃鹃, 葛瑛. 碳青霉烯类耐药肠杆菌科细菌感染治疗研究进展. 中国感染与化疗杂志, 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

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content