Pathogen spectrum and drug susceptibility analysis of intra-abdominal infections in different populations in Shandong Province,2017-2022
Objective To analyze the pathogen spectrum and drug resistance in different age groups of acites in Shandong Province,and provide a reference for early empirical therapy of intra-abdominal infection.Methods WHONET5.6 analysis software was used to retrospectively analyze the pathogenic bacteria composition and drug susceptibility of the main pathogens reported by SPARSS network members in Shandong Province from 2017 to 2022.Results A total of 10,991 strains of pathogenic bacteria were enrolled in this study,mainly Gram-negative bacteria(57.1％),of which Enterobacteriaceae was dominant(83.73％),followed by non-fermentative bacteria(14.87％).Gram-positive bacteria accounted for 38.23％(4,202/10,991).The main Gram-positive bacteria were Staphylococcus spp.(14.94％),followed by Enterococcus spp.(14.73％).A total of 470 strains of fungi were detected.Candida albicans accounted for the highest proportion(53.4％),followed by Candida tropicalis(15.7％).The top 5 bacterial strains detected in adults were Escherichia coli(28.92％),Klebsiella pneumoniae(9.21％),Enterococcus faecalis(8.47％),Staphylococcus epidermidis(5.46％),and Enterococcus faecalis(4.35％).The top 5 bacterial strains detected in the children's group were Escherichia coli(51.18％),Pseudomonas aeruginosa(7.58％),Klebsiella pneumoniae(6.96％),Enterococcus faecalis(5.22％),and Staphylococcus epidermidis(2.48％).There were significant differences in the distribution of Gram-positive bacteria,Gram-negative bacteria and fungi between the children's group and the adults'group(x2=102.1,P＜0.0001).The proportion of ESBLs produced by Escherichia coli and Klebsiella pneumoniae isolated from ascites in Shangdong Province was 27.5％and 16.4％,respectively.The resistance rates of both bacteria to carbapenems were relative lower,at 1.4％and 3.8％,respectively.The drug resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii were generally high,with resistance rates to carbapenems of 9.5％and 56.3％,respectively.No vancomycin-resistant Enterococcus faecium,Enterococcus faecalis,or vancomycin-resistant Staphylococcus aureus were found in this period.The resistance of methicillin-resistant Staphylococcus aureus was 20.4％.The resistance rate of Candida tropicalis to fluconazole was as high as 37.3％.Conclusion The composition of pathogenic bacteria from acites in the Shandong region was different between children and adults.The detection rates of multidrug-resistant E.coli,K.pneumoniae and A.baumannii were higher,while the proportion of fluconazole resistant C.tropicalis was relatively high,which required special monitoring.Real-time monitoring of the pathogen spectrum and drug resistance trend of acites may help in the accurate diagnosis and treatment of intra-abdominal infections.
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