Distribution and antibiotic resistance of multidrug-resistant bacteria in a tertiary tuberculosis hospital

doi:10.3877/cma.j.issn.1674-0785.2018.03.006

Abstract

Abstract:

Objective

To analyze the distribution and antibiotic resistance of multidrug-resistant organisms (MDROS) isolated in Anhui Chest Hospital in 2016.

Methods

A retrospective analysis was performed of the distribution and drug sensitivity of 165 clinical isolates of MDROS in Anhui Chest Hospital in 2016.

Results

MDROS mainly included extended-spectrum beta-lactamase (ESBL) producing Escherichia coli, ESBL producing Klebsiella pneumoniae, carbopenem resistant Acinetobacter baumannii (CR-AB), methicillin resistant Staphylococcus aureus (MRSA), methicillin resistant coagulase negative staphylococci (MRCNS), and multidrug resistant/pandrug resistant Pseudomonas aeruginosa (MDRPA). Specimens from which MDROS were isolated mainly included sputum, lavage fluid, and urine. Multidrug resistant Acinetobacter baumannii had the lowest resistance rate to amikacin (57%). ESBL producing Escherichia coli had the lowest resistance rates to imipenem and meropenem (0% for both). The sensitivity rates of ESBLs producing Klebsiella pneumoniae to imipenem and meropenem were both 86.8%. MDRPA had the lowest resistance rates to gentamicin and amikacin (11.6% and 17.3%, respectively). The sensitivity rates of MRSA and MRCNS to vancomycin and linezolid were both 100%.

Conclusions

The drug resistance of multidrug resistant bacteria is serious. Imipenem or meropenem has good antibacterial activity against ESBL producing Klebsiella pneumoniae and Escherichia coli, although carbapenem resistant Enterobacteriaceae strains have been detected. Amikacin and gentamicin have good antibacterial activity against CR-AB and MDRPA. Vancomycin and linezolid have the strongest antibacterial activity against MRSA and MRCNS.

Key words: Multidrug resistance, Multidrug-resistant organisms, Antibiotics

Jingli Zhao, Dongping Wang, Xundi Bao, Qing Wang. Distribution and antibiotic resistance of multidrug-resistant bacteria in a tertiary tuberculosis hospital[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(03): 152-155.

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References 12

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菌种	药敏结果	青霉素G	苯唑西林	阿莫西林/克拉维酸	头孢西丁	阿米卡星	庆大霉素	妥布霉素	利福平	环丙沙星
MRSA	耐药	100	100	100	100	43.8	62.5	66.7	43.8	68.8
?	中介	0	0	0	0	6.2	0	0	0	0
?	敏感	0	0	0	0	50.0	37.5	33.3	56.2	31.2
MRCNS	耐药	100	100	44.0	100	11.1	55.6	53.8	44.4	80.8
?	中介	0	0	0	0	3.7	7.4	11.6	0	0
?	敏感	0	0	56.0	0	85.2	37	34.6	55.6	19.2
菌种	药敏结果	复方新诺明	克林霉素	红霉素	呋喃妥因	利奈唑胺	万古霉素	替考拉宁	奎奴普丁/达福普汀	四环素
MRSA	耐药	18.8	64.3	68.8	0	0	0	6.2	6.2	62.5
?	中介	0	0	6.2	16.7	0	0	0	0	6.3
?	敏感	81.2	35.7	25.0	83.3	100	100	93.8	93.8	31.2
MRCNS	耐药	66.7	87.5	92.3	0	0	0	0	18.5	37.0
?	中介	0	0	0	0	0	0	7.7	3.7	7.4
?	敏感	33.3	12.5	7.7	100	100	100	92.3	77.8	55.6

菌种	药敏结果	青霉素G	苯唑西林	阿莫西林/克拉维酸	头孢西丁	阿米卡星	庆大霉素	妥布霉素	利福平	环丙沙星
MRSA	耐药	100	100	100	100	43.8	62.5	66.7	43.8	68.8
?	中介	0	0	0	0	6.2	0	0	0	0
?	敏感	0	0	0	0	50.0	37.5	33.3	56.2	31.2
MRCNS	耐药	100	100	44.0	100	11.1	55.6	53.8	44.4	80.8
?	中介	0	0	0	0	3.7	7.4	11.6	0	0
?	敏感	0	0	56.0	0	85.2	37	34.6	55.6	19.2
菌种	药敏结果	复方新诺明	克林霉素	红霉素	呋喃妥因	利奈唑胺	万古霉素	替考拉宁	奎奴普丁/达福普汀	四环素
MRSA	耐药	18.8	64.3	68.8	0	0	0	6.2	6.2	62.5
?	中介	0	0	6.2	16.7	0	0	0	0	6.3
?	敏感	81.2	35.7	25.0	83.3	100	100	93.8	93.8	31.2
MRCNS	耐药	66.7	87.5	92.3	0	0	0	0	18.5	37.0
?	中介	0	0	0	0	0	0	7.7	3.7	7.4
?	敏感	33.3	12.5	7.7	100	100	100	92.3	77.8	55.6

菌种	例数	药敏结果	哌拉西林	阿莫西林/克拉维酸	哌拉西林/他唑巴坦	头孢唑啉	头孢他啶	头孢噻肟	头孢吡肟	亚胺培南	美洛培南	阿米卡星	庆大霉素	环丙沙星	左旋氧氟沙星	复方新诺明	四环素
ESBLs肺炎克雷伯菌	39	耐药	92.5	90.6	52.8	92.2	62.3	88.7	73.6	13.2	11.3	26.4	54.7	53.8	45.3	83.0	64.2
ESBLs肺炎克雷伯菌	?	中介	5.6	0	0	0	7.5	0	7.5	0	1.9	0	1.9	5.8	7.5	0	0
?	?	敏感	1.9	9.4	47.2	7.8	30.2	11.3	18.9	86.8	86.8	73.6	43.4	40.4	47.2	17.0	35.8
ESBLs大肠埃希菌	45	耐药	100	100	36.0	96.4	75.0	96.4	89.3	0	0	29.0	64.4	93.0	96.4	100	93.0
ESBLs大肠埃希菌	?	中介	0	0	0	0	7.0	0	3.6	0	0	0	3.6	0	0	0	0
?	?	敏感	0	0	64.0	3.6	18.0	3.6	7.1	100	100	71.0	32.0	7.0	3.6	0	7.0
CR-AB	19	耐药	91.0	100	100	100	100	100	100	81.0	81.0	57.0	95.2	91.0	91.0	100	76.2
?	?	中介	9.0	0	0	0	0	0	0	0	0	24.0	0	4.8	0	0	0
?	?	敏感	0	0	0	0	0	0	0	19.0	19.0	19.0	4.8	4.2	9.0	0	23.8
MDRPA	18	耐药	42.3	100	68.6	100	32.7	94.2	38.5	30.8	27.5	11.6	17.3	46.2	48.1	91.8	73.8
?	?	中介	13.5	0	2.0	0	11.5	5.8	26.9	21.1	5.8	3.8	13.5	7.6	21.1	0	0
?	?	敏感	44.2	0	29.4	0	55.8	0	34.6	48.1	66.7	84.6	69.2	46.2	30.8	8.2	26.2

菌种	例数	药敏结果	哌拉西林	阿莫西林/克拉维酸	哌拉西林/他唑巴坦	头孢唑啉	头孢他啶	头孢噻肟	头孢吡肟	亚胺培南	美洛培南	阿米卡星	庆大霉素	环丙沙星	左旋氧氟沙星	复方新诺明	四环素
ESBLs肺炎克雷伯菌	39	耐药	92.5	90.6	52.8	92.2	62.3	88.7	73.6	13.2	11.3	26.4	54.7	53.8	45.3	83.0	64.2
ESBLs肺炎克雷伯菌	?	中介	5.6	0	0	0	7.5	0	7.5	0	1.9	0	1.9	5.8	7.5	0	0
?	?	敏感	1.9	9.4	47.2	7.8	30.2	11.3	18.9	86.8	86.8	73.6	43.4	40.4	47.2	17.0	35.8
ESBLs大肠埃希菌	45	耐药	100	100	36.0	96.4	75.0	96.4	89.3	0	0	29.0	64.4	93.0	96.4	100	93.0
ESBLs大肠埃希菌	?	中介	0	0	0	0	7.0	0	3.6	0	0	0	3.6	0	0	0	0
?	?	敏感	0	0	64.0	3.6	18.0	3.6	7.1	100	100	71.0	32.0	7.0	3.6	0	7.0
CR-AB	19	耐药	91.0	100	100	100	100	100	100	81.0	81.0	57.0	95.2	91.0	91.0	100	76.2
?	?	中介	9.0	0	0	0	0	0	0	0	0	24.0	0	4.8	0	0	0
?	?	敏感	0	0	0	0	0	0	0	19.0	19.0	19.0	4.8	4.2	9.0	0	23.8
MDRPA	18	耐药	42.3	100	68.6	100	32.7	94.2	38.5	30.8	27.5	11.6	17.3	46.2	48.1	91.8	73.8
?	?	中介	13.5	0	2.0	0	11.5	5.8	26.9	21.1	5.8	3.8	13.5	7.6	21.1	0	0
?	?	敏感	44.2	0	29.4	0	55.8	0	34.6	48.1	66.7	84.6	69.2	46.2	30.8	8.2	26.2

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