The Clinical Distribution and Changes of Drug Resistance for Carbapenem-resistant Organism in a Beijing Tertiary Hospital From 2018 to 2022
Objective To better understand the distribution of clinical isolates of Carbapenem-resistant organism (CRO),drug resistance and prevalence of CRO in a tertiary first-class hospital in Beijing area,and to learn changes of drug resistance of CRO,so as to provide evidences for a rational use of antimicrobial agents.Methods Specimen information and antimicrobial susceptibility data of CRO isolated from cultured specimens of clinical departments from 2018 to 2022 were collected.Statistical analysis was conducted by WHONET5.6.Results A total of 930 CRO strains were isolated in the past five years.The number of Carbapenem-resistance Pseudomonas aeruginosa (CRPA)was 279 strains (30％),while the number of Carbapenem-resistance Acinetobacter baumannii (CRAB ) was 233 strains (25.05％),and the number of Carbapenem-resistance Klebsiella pneumoniae(CRKP)was 196 strains (21.08％).CRO was the most common in the Department of ICU (250 strains,26.88％),followed by the Department of Observation Room of Emergency (146 strains,15.70％).CRO strains were mainly isolated from sputum (638 strains,68.60％),followed by urine (99 strains,10.65％).Analysis of drug resistance of three main CRO strains showed:CRPA was susceptible to amikacin and tobramycin,with susceptibility rates of 90.5％ and 84.6％,respectively.CRAB and CRKP drug resistance situations were relatively severe,with a universal resistance to commonly used antibiotics.From 2018 to 2022,the resistance rate of Kpn to imipenem (IPM)and meropenem (MEM)increased yearly,while the resistance rate of Aba and Pae to carbapenems fluctuated.The drug resistance rate in 2022 decreased,compared with 2021,while increased compared with 2018.Conclusion The isolation CRO strains are mainly from sputum,the Department of ICU.The drug resistance situations of CRPA,CRAB and CRKP are relatively severe.There is an overall upward trend of resistance rates of Pae,Aba,and Kpn to carbapenem antibiotics.The hospital should strengthen measures for prevention and control of hospital infection,clinicians develop medication plans based on drug sensitivity results.The management of clinical use of carbapenem antimicrobial agents should be strengthened to prevent and control the potential outbreak and prevalence of CRO.
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