CHI Na, ZHANG Yumei
Objective To understand the species, drug resistance and changes of multi-drug resistant bacteria (MDRO) in a hospital in recent 3 years, so as to provide basis for the prevention and control of nosocomial infection and clinical rational drug use.Methods By using the method of retrospective analysis, the detection and drug sensitivity test data of multi-drug resistant bacteria in the samples of inpatients in the hospital from 2017 to 2019 were collected, and the species, drug resistance and changes of multi-drug resistant bacteria were analyzed. Results Totally 933 strains of multi-drug-resistant bacteria were detected in our hospital from January 2017 to December 2019. The main sources of multi-drug-resistant bacteria infection samples were sputum (30.12%), followed by urine (30.01%), secretion (28.51%), blood (10.40%) and so on. Gram-negative bacteria accounted for 83.49%, and Gram-positive bacteria accounted for 16.51%. The top 5 strains of 923 strains were Escherichia coli producing extended-spectrum β-lactamase (ESBLs), Klebsiella pneumoniae producing ESBLs, methicillin-resistant Staphylococcus aureus (MRSA), Carbapenem-resistant Acinetobacter baumannii (CR-AB), multidrug-resistant Pseudomonas aeruginosa (MDR-PA). The resistance rate of ESBLs positive multidrug resistant bacteria to penicillins, ceftriaxone and cefazolin was more than 90% ,and the sensitivity to carbapenem, aminoglycosides,cefoperazone/sulbactam was more than 90%, especially to ertapenem (99.4%-100%). The resistance rate of Pseudomonas aeruginosa to ticacillin/clavulanic acid, imipenem and nitrofurantoin was more than 70%, but the sensitivity to tobramycin was 92.9%. Acinetobacter baumannii was highly resistant to cephalosporins, imipenem, aminoglycosides, quinolones and other common antibiotics, with a resistance rate of more than 95% and a sensitivity of 90.2% only to cefoperazone/sulbactam. The resistance rate of MRSA to penicillins was 100%.Conclusion The infection of multi-drug resistant bacteria in the hospital is becoming more and more serious in the past three years. Escherichia coli (producing ESBLs) in Gram-negative bacteria decreased year by year, Klebsiella pneumoniae (producing ESBLS) increased at first and then decreased, and Gram-positive bacteria MRSA increased year by year. However, the infection of multi-drug-resistant bacteria in the hospital is still mainly Gram-negative bacteria. We should strengthen the monitoring of multi-drug-resistant bacteria, select antibiotics reasonably.