Distribution and Antimicrobial Resistance of Gram-Negative Bacilli of Two Hospitals in Shandong Province from 2018 to 2020
Objective:To investigate the prevalence and drug resistance of Gram-negative bacilli(GNB)in the Affiliated Hospital of Medical College Qingdao University(QDUH)and Shandong Provincial Hospital Affiliated to Shandong First Medical University(SPH)from 2018 to 2020.Methods:All strains were obtained from the QDUH and SPH as part of the Surveillance of Multicenter Antimicrobial Resistance(SMART)project in China and identified and tested at the SMART Center Laboratory.Strains were tested for antimicrobial susceptibility using the Trek Diagnostic System withpersonalized antimicrobial panels,andthe minimum inhibitory concentration values were interpreted according to the Performance Standards for Antimicrobial Susceptibility Testing(Version 32),published in 2022.The study compared theoverall detection rates of GNB,the detection rates of GNB in Intensive Care Units(ICU)and non-ICU wards,and the resistance rates to conventional antimicrobial drugs between the two hospitals.Results:A total of 1,727 non-repetitive GNB were collected from the two hospitals.Escherichia coli(E.coli),Klebsiella pneumoniae(K.pneumoniae),Pseudomonas aeruginosa(P.aeruginosa)and Acinetobacter baumannii(A.baumannii)accounted for 35.38%,20.09%,15.87%and 11.41%of total strains,respectively.There were significant differences in the detection rate of GNB between the ICU and non-ICU wards in both hospitals.The ICU had a lower detection rate of E.coli,but significantly higher detection rates of K.pneumoniae,P.aeruginosa,and A.baumannii compared to the non-ICU(P＜0.05).In term of drug resistance,E.coli in the ICUs of both hospitals exhibited very low resistance rates to carbapenems,amikacin and colistin.However,in the ICU of the SPH,the drug resistance rates of K.pneumoniae to all antimicrobial agents,except colistin,were significantly higher than those in the QDUH.The resistance rates were approximately 1-4 times higher in the ICU compared to the non-ICU of the same hospital,and approximately twice as high compared to the QDUH.Additionally,P.aeruginosa in the ICU of the SPH showed higher drug resistance rates to common antimicrobial agents(meropenem,amikacin,colistin,levofloxacin,piperacillin-tazobactam,etc)compared to the QDUH.Colistin was the only effective drug against A.baumannii in both ICUs and non-ICUs of the two hospitals.Conclusion:Differences in the resistance rates of major GNB to antimicrobial agents between ICU and non-ICU wards in QDUH and SPH were observed,despite both being located in Shandong Province.These findings highlight the importance of clinical surveillance of GNB epidemiology and bacterial resistance in our hospital,whichisessentialfor providing reliable evidence of antimicrobial agents use to reduce the risk of resistant bacterial transmission.
Gram-negative bacteriaEnterobacteriaceaeantimicrobial agentsdrug resistanceintensive care unit
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