Drug resistance of pathogens causing nosocomial infection in orthopedics from 2012 to 2017: a 6-year retrospective study

Journal of Orthopaedic Surgery and Research

Niya Hu¹  Jiaxiang Xu²  Qi Lai²  Banglin Xie²  Lijun Wan²  Runsheng Guo²  Xiaowei Yang²  Min Dai²  Bin Zhang² 

[1] Department of Laboratory, First Affiliated Hospital of Nanchang University, No. 17 Yong Wai Zheng Street, 330006, Nanchang, Jiangxi, China;Department of Orthopedics, First Affiliated Hospital of Nanchang University, No. 17 Yong Wai Zheng Street, 330006, Nanchang, Jiangxi, China;

关键词: Hospital-acquired infections;    Orthopedics;    Drug resistance;    Multidrug resistance;   

DOI  :  10.1186/s13018-021-02234-7

来源: Springer

【 摘 要 】

BackgroundHospital-acquired infections (HAIs) are an emerging global problem that increases in-hospital mortality, length of stay, and cost. We performed a 6-year retrospective study to provide valuable insight into appropriate antibiotic use in HAI cases. We also aimed to understand how hospitals could reduce pathogen drug resistance in a population that overuses antibiotics.MethodsAll data (2012–2017) were obtained from the hospital information warehouse and clinical microbiology laboratory.ResultsWe isolated 1392 pathogen strains from patients admitted to the orthopedics department during 2012–2017. Escherichia coli (14.7%, 204/1392), Enterobacter cloacae (13.9%, 193/1392), and Staphylococcus aureus (11.3%, 157/1392) were the most common pathogens causing nosocomial infections. The dominant Gram-negative bacterium was E. coli, with high resistance to ampicillin, levofloxacin, cotrimoxazole, gentamicin, and ciprofloxacin, in that order. E. coli was least resistant to amikacin, cefoperazone-sulbactam. The most dominant Gram-positive bacterium was S. aureus, highly resistant to penicillin and ampicillin, but not resistant to fluoroquinolones and cotrimoxazole. Analysis of risk factors related to multidrug-resistant bacteria showed that patients with open fractures (Gustillo III B and IIIC) were significantly more susceptible to methicillin-resistant S. aureus infections (p < 0.05). Additionally, extended-spectrum β-lactamase-producing E. coli infections occurred significantly more often in patients with degenerative diseases (p < 0.05). Elderly patients tended to be more susceptible to multidrug-resistant bacterial infections, but this outcome was not statistically significant.ConclusionsAntimicrobial resistance is a serious problem in orthopedics. To effectively control antimicrobial resistance among pathogens, we advocate extensive and dynamic monitoring of MDR bacteria, coupled with careful use of antibiotics.

【 授权许可】

CC BY