Analysis of distribution and drug resistance of pathogens in burned patients / 上海交通大学学报（医学版）

ABSTRACT

Objective • To provide guidance for the rational usage of antibiotics, reduction of drug-resistant strains and hospital infection control by investigating the distribution and drug resistance of pathogens isolated from burned patients. Methods • Isolates from burned patients of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between Jan. 2016 and Dec. 2017 were collected. The VITEK 2 Compact automatic microbial analysis system and K-B disc diffusion method were used for antimicrobial susceptibility test. Statistical analysis was performed to investigate the type of specimens and strains and the resistance rates of major pathogens. Chi-square test was used to compare the changes of the detection rates and drug resistance rates of major pathogens between 2016-2017 and 2013-2014. Results • A total of 1 053 isolates were isolated, and most of them (73.88%) were from wounds. Among them, 609 (57.83%) isolates were gram-negative bacilli (G-B), 422 (40.08%) were gram-positive cocci (G+C) and 9 (0.85%) were fungi. The most common pathogen of G-B was Klebsiella pneumoniae (218, 20.70%) in 2016-2017, the proportion of which was significantly higher than that in 2013-2014 (114, 10.72%) (P=0.000). The most common pathogen of G+C was Staphylococcus aureus (210, 19.94%), the proportion of which was significantly higher than that in 2013-2014 (200, 18.81%) (P=0.009). K. pneumoniae showed low resistance only to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, meropenem, fosfomycin and tigecycline (90%). The resistance rates of K. pneumoniae to ceftazidime, cefepime, imipenem, meropenem and amikacin in 2016-2017 were significantly higher than those in 2013-2014 (P<0.05). S. aureus was only resistant highly to penicillin (94.63%) and 100% susceptible to vancomycin and linezolid. The proportion of methicillin-resistant S. aureus (MRSA) was 59.05% in 2016-2017, which had no statistical difference compared with that in 2013-2014 (P=0.412). Conclusion • The most two prevalent isolates from burned patients were K. pneumoniae and S. aureus with multi-drug resistance. Improved management and rational use of antibiotics can reduce the incidence of antibiotic resistant pathogens, and it's still important to keep routine surveillance on pathogens isolated from burned patients for control and prevention of nosocomial infections.