Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2019; 7(20): 3175-3184
Published online Oct 26, 2019. doi: 10.12998/wjcc.v7.i20.3175
Distribution and drug resistance of pathogenic bacteria in emergency patients
Wei Huai, Qing-Bian Ma, Jia-Jia Zheng, Yang Zhao, Qiang-Rong Zhai
Wei Huai, Qing-Bian Ma, Qiang-Rong Zhai, Emergency Department, Third Clinical Medical College, Peking University, Beijing 100191, China
Jia-Jia Zheng, Yang Zhao, Laboratory Department, Third Clinical Medical College, Peking University, Beijing 100191, China
Author contributions: Huai W designed research, performed research and wrote the paper; Ma QB designed research; Zheng JJ performed research; Zhao Y analyzed data; Zhai QR performed research.
Institutional review board statement: This study was approved by the Ethics Committee of Peking University Third Hospital, China.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qing-Bian Ma, MD, Chief Doctor, Emergency Department, Third Clinical Medical College, Peking University, No. 49 Huayuan North Road, Haidian District, Beijing 100191, China. maqingbian@medmail.com.cn
Telephone: +86-10-82264047 Fax: +86-10-82264040
Received: June 22, 2019
Peer-review started: June 23, 2019
First decision: July 31, 2019
Revised: August 23, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 26, 2019
Processing time: 126 Days and 14.9 Hours
Abstract
BACKGROUND

Antibiotic resistance has become a global threat for human health, calling for rational use of antibiotics.

AIM

To analyze the distribution and drug resistance of the bacteria, providing the prerequisite for use of antibiotics in emergency patients.

METHODS

A total of 2048 emergency patients from 2013 to 2017 were enrolled. Their clinical examination specimens were collected, followed by isolation of bacteria. The bacterial identification and drug susceptibility testing were carried out.

RESULTS

A total of 3387 pathogens were isolated. The top six pathogens were Acinetobacter baumannii (660 strains), Staphylococcus aureus (436 strains), Klebsiella pneumoniae (347 strains), Pseudomonas aeruginosa (338 strains), Escherichia coli (237 strains), and Candida albicans (207 strains). The isolation rates of these pathogens decreased year by year except Klebsiella pneumoniae, which increased from 7.1% to 12.1%. Acinetobacter baumannii is a widely-resistant strain, with multiple resistances to imipenem, ciprofloxacin, minocycline and tigecycline. The Staphylococcus aureus had high resistance rates to levofloxacin, penicillin G, and tetracycline. But the susceptibility of it to vancomycin and tigecycline were 100%. Klebsiella pneumoniae had high resistance rates to imipenem, cefoperazone/sulbactam, amikacin, and ciprofloxacin, with the lowest resistance rate to tigecycline. The resistance rates of Pseudomonas aeruginosa to cefoperazone/sulbactam and imipenem were higher, with the resistance rate to amikacin below 10%. Besides, Escherichia coli had high resistance rates to ciprofloxacin and cefoperazone/sulbactam and low resistance rates to imipenem, amikacin, and tigecycline.

CONCLUSION

The pathogenic bacteria isolated from the emergency patients were mainly Acinetobacter baumannii, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans. The detection rates of drug-resistant bacteria were high, with different bacteria having multiple drug resistances to commonly used antimicrobial agents, guiding the rational use of drugs and reducing the production of multidrug-resistant bacteria.

Keywords: Distribution; Drug resistance; Bacteria; Emergency department

Core tip: The purpose of this study is to analyze the distribution and drug resistance of the bacteria isolated from the emergency department specimens, providing the prerequisite for rational use of antibiotics in emergency patients. The top six pathogens were Acinetobacter baumannii (660 strains), Staphylococcus aureus (436 strains), Klebsiella pneumoniae (347 strains), Pseudomonas aeruginosa (338 strains), Escherichia coli (237 strains), and Candida albicans (207 strains). The detection rates of drug-resistant bacteria were high, with different bacteria having multiple drug resistances to commonly used antimicrobial agents, guiding the rational use of drugs and reducing the production of multidrug-resistant bacteria.