Analysis of Antimicrobial Resistance in Peking Union Medical College Hospital in 2019

  Objective  To investigate the antimicrobial resistance of clinical bacterial isolates in Peking Union Medical College Hospital (PUMCH) in 2019.

  Methods  The antimicrobial resistance of 11 404 non-duplicated common bacteria isolated from PUMCH during January 1 to December 31, 2019 were retrospectively analyzed.

  Results  In the totally 11 404 clinical isolates, Gram-negative bacilli and gram-positive cocci accounted for 63.8% (7276/11 404) and 36.2% (4128/11 404), respectively. Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-resistant coagulase-negative Staphylococcus(MRCNS) accounted for 18.9%(191/1009) and 77.3% (659/853), respectively, both of which had a high resistance rate to erythromycin (79.6%, 83.2%). Enterococcus faecium and Enterococcus faecalis accounted for 38.2% (437/1143) and 54.6% (624/1143) in Enterococci, respectively; and the resistance rates to linezolid (0.2%, 0.3%), vancomycin (4.3%, 0.2%) and teicoplanin (3.0%, 0) were low. The detection rates of Streptococcus pneumoniae, α -hemolytic Streptococcus, group A and group B β -hemolytic Streptococcus were 12.8% (130/1012), 37.9%(384/1012), 4.2% (43/1012) and 39.0% (395/1012) in Streptococcus, respectively. The resistance rates of all strains to erythromycin, azithromycin and clindamycin were more than 88.7% in Streptococcus pneumoniae and group β -hemolytic Streptococcus. Among the Enterobacteriaceae, the detection rates of carbapenem resistant Enterobacteriaceae(CRE) and extensive drug resistance (XDR) strains in Klebsiella pneumoniae were 7.1%(308/4324) and 4.7% (60/1273), respectively. The resistance rates of Enterobacteriaceae to tigecycline, carbapenems and amikacin were low. Among the non-fermentative Gram negative bacilli, Acinetobacter baumannii had the lowest resistance rate to tigecycline (6.9%) and the highest resistance rate to piperacillin (93.3%); Pseudomonas aeruginosa had the lowest resistance rate to amikacin (4.5%) and the highest resistance rate to levofloxacin (22.6%). The detection rates of XDR strains in Acinetobacter baumannii and Pseudomonas aeruginosa were 12.3% (117/949) and 1.8%(21/1137), repectively. Among Haemophilus influenzae, the positive rate of β-lactamase was 34.1%(45/132); the resistance rate to ampicillin was the highest (62.9%); the resistance rate to other antibiotics except chloramphenicol were 33.3%-48.4%.

  Conclusions  The common bacteria isolated from PUMCH in 2019 have different degrees of resistance to commonly used antibiotics, which may play a guiding role in the rational use and scientific management of antibiotics.