Epidemiological characteristics and drug resistance of multidrug-resistant organisms in a three-A obstetrics and gynecology hospital from 2020 to 2022
OBJECTIVE To explore the clinical distribution and drug resistance of multidrug-resistant organisms(MDROs)from the patients of obstetrics and gynecology department so as to provide bases for formulating effec-tive intervention measures for prevention and control and reasonable clinical use of antibiotics.METHODS By means of retrospective analysis,the isolated MDROs strains were collected from the patients who were hospital-ized in the Obstetrics and Gynecology Hospital of Fudan University from Jan 2020 to Dec 2022.The prevalence of MDROs infections,distribution in departments,specimen sources and drug resistance were observed.RESULTS Totally 5 257 strains of bacteria were isolated,1 308 of which were MDROs and were isolated from 1 168 patients,and the isolation rate of MDROs was 24.88％.There were 59 strains of methicillin-resistant Staphylococcus aureus(MR-SA),1 143 strains of extended-spectrum β-lactamases(ESBLs)-producing Escherichia coli,91 strains of ESBLs-produ-cing Klebsiella pneumoniae,9 strains of carbapenem-resistant E.coli(CREC),5 strains of carbapenem-resistant K.pneumoniae(CRKP)and 1 strain of carbapenem-resistant Acinetobacter baumannii(CRAB).No strains of vancomycin-resistant Enterococcus(VRE)and carbapenem-resistant P.aeruginosa(CPA)were detected.Among the patients from whom the MDROs were isolated,15.24％were from obstetrics department,82.96％from gynecology department,1.71％from neonatology department,0.09％from breast department.Among specimens sources,there were 409(31.27％)strains that were isolated from urine,386(29.51％)strains that were isolated from vaginal secretion speci-mens and 145(11.09％)strains that were isolated from cervical secretions.The 1 308 strains of MDROs were isolated from 584(44.65％)case-times of patients with nosocomial infection,184(14.07％)case-times of patients with com-munity-acquired infection and 540(41.28％)case-times of patients with colonization.The drug resistance rates of the ESBLs-producing E.coli and K.pneumoniae strains to carbapenems,piperacillin-tazobactam,cefotetan and amikacin were low,while the strains were highly resistant to other antibiotics.The MRSA strains were sensitive to vancomycin,tigecycline,linezolid,nitrofurantoin and quinupristin-dalfopristin,and the drug resistance rates to sulfamethoxazole-me-thoxazine,rifampicin and moxifloxacin were low.CONCLUSION The isolation rate of CRE is not high in the obstet-rics and gynecology hospital.The ESBLs-producing E.coli and K.pneumoniae are dominant among the MDROs,most of which are isolated from the patients with gynecologic tumors.It is necessary for the hospital to carry out active screening of the enrolled target patients and intensify the prevention and control of the infections as well as the clinical management of antibiotics.
Multidrug-resistant organismObstetrics and gynecology departmentClinical distributionDrug re-sistanceEpidemiology
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