Surveillance of antimicrobial resistance of clinical bacterial isolates in a hospital during 2013 / 中国感染与化疗杂志

ABSTRACT

Objective To investigate the antibiotic resistance of clinical isolates from hospital for the guidance of rational use of antibiotics .Methods Automatic VITEK‐2 system was used to identify bacterial strains and analyze the antimicrobial resistance . WHONET 5 .6 was applied for data analysis according to the breakpoints of Clinical and Laboratory Standards Institute 2013 . Results A total of 3 880 nonduplicate strains were collected in 2013 ,35 .2% (1 366/3 880) of which were gram positive organisms ,64 .8% (2 514/3 880) were gram negative bacteria .The top 6 most frequently isolated microorganisms were E . coli (20 .2% ) , K . pneumoniae (12 .0% ) , P . aeruginosa (11 .1% ) , coagulase negative Staphylococcus (9 .8% ) , A . baumannii (9 .8% ) ,E .f aecalis (8 .1% ) .The bacteria were mainly isolated from respiratory tract (51 .0% ) ,urine (26 .2% ) , and blood (9 .4% ) .The prevalence of both meticillin‐resistant Staphylococcus was higher than 72 .0% .No staphylococcal strainwasfoundresistanttolinezolid,vancomycinortigecycline.Amongthe509Enterococcusisolates,E.faecalisandE. f aecium accounted for 61 .5% and 32 .8% ,respectively .No enterococcal strain was resistant to vancomycin or tigecycline . Enterococcal isolates also showed low resistance (<2 .0% ) to teicoplanin and linezolid .About 67 .4% of the E .coli strains and 32 .0% of the K lebsiella isolates produced extended spectrumbeta‐lactamases.Thestrainsof E.coli,Klebsiella spp.,Enterobacterspp.,and Proteusspp.wererelatively susceptible to beta‐lactam/beta‐lactamase inhibitor combinations such as cefoperazone‐sulbactam and piperacillin‐tazobactam , carbapenems such as meropenem ,imipenem and ertapenem ,and amikacin (< 15 .0% of the strains were resistant) . K . pneumoniae isolates were more resistant than other gram‐negative bacilli .P .aeruginosa was relatively susceptible to amikacin , tobramycin ,cefepime ,gentamicin ,piperacillin‐tazobactam ,but more than 20% of these strains were resistant to meropenem and imipenem .More than 35 .0% of the A . baumannii isolates were resistant to any of the antimicrobial agents tested . Conclusions Antimicrobial resistance is still a serious threat in clinical antimicrobial therapy .It is important to promote the rational use of antimicrobial agents so that resistance is minimized . It is necessary to conduct epidemiological survey and proactively implement effective interventions in the clinical setting with relatively heavy burden of antimicrobial resistance .