Changes of multidrug-resistant organisms in a tertiary general hospital around overall relocation_West China Medical Journal

Authors：

ZHANG Ju ¹ , LI Xiaojing ¹ , CHEN Min ² , LI Gang ³ , LUO Min ⁴ , CHEN Jie ⁵ , ZENG Xia ⁶ , YANG Junhua ¹ , ZENG Fengmei ¹ ,  MA Li ⁷ , LEI Hong ⁸ , PENG Limeng ⁹

1. Department of Nosocomial Infection Management, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
2. Department of Ophthalmology, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
3. Department of Traditional Chinese Medicine, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
4. Department of Clinical Laboratory, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
5. Department of Surgical Anesthesia Center, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
6. Department of Gastroenterology, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
7. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
8. Department of Health Checkup Center, the First People’s Hospital of Longquanyi District of Chengdu, West China Longquan Hospital Sichuan University, Chengdu, Sichuan 610100, P. R. China;
9. Ping’an Community Health Center of Longquanyi District, Chengdu, Sichuan 610100, P. R. China;

Corresponding author：

MA Li, Email: 1004500237@qq.com

Keywords：

Tertiary general hospital; overall relocation; multidrug-resistant organism; change

DOI：

10.7507/1002-0179.202112111

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Objective To investigate the changes of multidrug-resistant organisms (MDROs) in the First People’s Hospital of Longquanyi District of Chengdu around its overall relocation. Methods The First People’s Hospital of Longquanyi District of Chengdu was overall relocated on December 31st, 2016. The detection rates of MDROs and the changes in nosocomial infections before the relocation (from 2015 to 2016) and after the relocation (from 2017 to 2020) were retrospectively analyzed. Results A total of 83634 qualified specimens were submitted for inspection, 8945 strains of pathogenic bacteria were detected, and the detection rate of pathogenic bacteria was 10.70%, showing an increasing trend in yearly detection rates of pathogenic bacteria (χ²_trend=8.722, P=0.003); among them, 1551 MDRO strains were detected, and the detection rate of MDROs was 17.34%, showing an increasing trend in yearly detection rates of MDROs (χ²_trend=11.140, P=0.001). The detection rate of pathogenic bacteria before relocation was lower than that after relocation, and the difference was statistically significant (9.64% vs. 11.08%; χ²=35.408, P<0.001); there was no significant difference in the detection rate of MDROs before and after relocation (16.32% vs. 17.66%; χ²=2.050, P=0.152). From 2015 to 2020, the detection rates of pathogenic bacteria from sputum+throat swab specimens (χ²_trend=81.764, P<0.001) and secretion+pus specimens (χ²_trend=56.311, P<0.001) showed increasing trends, while the detection rates of pathogenic bacteria from blood specimens (χ²_trend=110.400, P<0.001), urine specimens (χ²_trend=11.919, P=0.001), and sterile body fluid specimens (χ²_trend=20.158, P<0.001) showed decreasing trends. The MDRO detection rates of Escherichia coli (χ²_trend=21.742, P<0.001), Staphylococcus aureus (χ²_trend=47.049, P<0.001), and Pseudomonas aeruginosa (χ²_trend=66.625, P<0.001) showed increasing trends, while the MDRO detection rates of Klebsiella pneumoniae (χ²_trend=2.929, P=0.087) and Acinetobacter baumannii (χ²_trend=0.498, P=0.481) showed no statistically linear trend, but the MDRO detection rate of Acinetobacter baumannii dropped significantly in 2017. In the targeted monitored MDROs, the proportions of nosocomial infections in methicillin-resistant Staphylococcus aureus (χ²_trend=4.581, P=0.032), carbapenem-resistant Enterobacteriaceae (χ²_trend=8.031, P=0.005), and carbapenem-resistant Pseudomonas aeruginosa (χ²_trend=6.692, P=0.010) showed decreasing trends; there was no statistically linear trend in the proportion of nosocomial infections in carbapenem-resistant Acinetobacter baumannii (χ²_trend=0.597, P=0.440); only one strain of vancomycin-resistant Enterococcus was detected in 2017, and no nosocomial infection occurred. Conclusions The overall detection rate of pathogenic bacteria and MDROs in this tertiary general hospital around relocation showed increasing trends year by year. The detection rate of pathogenic bacteria after relocation was higher than that before relocation, but the detection rate of MDROs after relocation did not differ from that before relocation. The proportion of nosocomial infections among the targeted monitored MDROs decreased.

Citation： ZHANG Ju, LI Xiaojing, CHEN Min, LI Gang, LUO Min, CHEN Jie, ZENG Xia, YANG Junhua, ZENG Fengmei, MA Li, LEI Hong, PENG Limeng. Changes of multidrug-resistant organisms in a tertiary general hospital around overall relocation. West China Medical Journal, 2022, 37(3): 369-374. doi: 10.7507/1002-0179.202112111 Copy

1.	中华人民共和国卫生部. 卫生部办公厅关于印发《多重耐药菌医院感染预防与控制技术指南(试行)》的通知. 中华人民共和国卫生部公报, 2011(2): 59-61.
2.	胡付品, 郭燕, 朱德妹, 等. 2016 年中国 CHINET 细菌耐药性监测. 中国感染与化疗杂志, 2017, 17(5): 481-491.
3.	朱敬蕊, 崔琢, 汪振林, 等. 某三甲医院常见多重耐药菌流行趋势分析. 蚌埠医学院学报, 2020, 45(1): 94-97.
4.	陈国建, 杨洁, 邓艾, 等. 某综合医院常见多重耐药菌感染危险因素 logistic 回归分析. 华西医学, 2020, 35(3): 290-295.
5.	余佳佳, 李虎, 陶晓勤, 等. 2019 年上海交通大学医学院附属新华医院细菌耐药性监测. 中国抗生素杂志, 2021, 46(5): 442-449.
6.	蔡虻, 刘聚源. 多重耐药菌医院感染防控策略与思考. 中国护理管理, 2018, 18(12): 1590-1594.
7.	葛洁明, 范亚霞, 张文秋, 等. 2014-2018 年某三甲医院多重耐药菌的分布及趋势分析. 中国煤炭工业医学杂志, 2020, 23(3): 307-312.
8.	叶应妩, 王毓三, 申子瑜. 全国临床检验操作规程. 3 版. 南京: 东南大学出版社, 2006: 736-753.
9.	叶丹, 杨永红, 张婷, 等. 某医院下呼吸道感染分离菌分布及耐药性监测. 中国实验诊断学, 2020, 24(3): 386-389.
10.	Clinical and Laboratory Standard Institute. M100-S23 Performance standards for antimicrobial susceptibility testing: twenty-third informational supplement: CLSI document M100-S23. Wayne, PA: Clinical and Laboratory Standard Institute, 2013.
11.	李春辉, 吴安华. MDR、XDR、PDR 多重耐药菌暂行标准定义—国际专家建议. 中国感染控制杂志, 2014, 13(1): 62-64.
12.	黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识. 中国感染控制杂志, 2015, 14(1): 1-9.
13.	中华人民共和国国家卫生和计划生育委员会. 国家卫生计生委办公厅关于印发麻醉等 6 个专业质控指标（2015 年版）的通知: 国卫办医函〔2015﹞252 号. (2015-03-31)[2022-02-01]. http://www.nhc.gov.cn/yzygj/s7657/201504/5fa7461c3d044cb6a93eb6cc6eece087.shtml.
14.	李六亿, 吴安华. 胡必杰. 如何提高医院感染预防与控制能力. 北京: 北京大学医学出版社, 2015: 190-215.
15.	国家卫生健康委. 国家卫生健康委关于印发三级医院评审标准（2020 年版）的通知: 国卫医发〔2020﹞26 号. (2020-12-21)[2022-02-01]. http://www.nhc.gov.cn/yzygj/s7657/202012/c46f97f475da4d60be21641559417aaf.shtml.
16.	国家卫生健康委医院管理研究所. 关于印发“提高住院患者抗菌药物治疗前病原学送检率”专项行动指导意见的函: 国卫医研函〔2021﹞198 号. (2021-10-28)[2022-02-01]. https://www.qiluhospital.com/uploadfile/2022/0120/20220120105510227.pdf.
17.	刘卫平, 焦月英, 海云婷, 等. 某医院多重耐药菌感染分布趋势与耐药性分析. 中国消毒学杂志, 2018, 35(12): 931-933, 936.
18.	张毅, 彭玲玲, 黄丽玲. 广东某军队医院 2019 年多重耐药菌检出现状及耐药性分析. 东南国防医药, 2021, 23(1): 45-49.
19.	林秀娟, 林红燕, 钟韵. 某三甲医院 2014-2016 年多重耐药菌感染趋势变迁. 广东医学, 2018, 39(1): 107-110.
20.	National Center Emerging and Zoonotic Infectious Disease. Facility guidance for control of carbapenem-resistant Enterobacteriaceae (CRE). (2015-12-17)[2021-12-01]. http://www.cdc.gov/hai/pdfs/cre/CRE-guidance-508.pdf.
21.	World Health Organization. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities. Geneva: World Health Organization, 2017. http://apps.who.int/iris/bitstream/10665/259462/1/9789241550178-eng.pdf?ua=1.
22.	Tacconelli E, Cataldo MA, Dancer SJ, et al. ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients. Clin Microbiol Infect, 2014, 20(Suppl 1): 1-55.
23.	World Health Organization. Infection prevention and control. [2022-03-03]. https://www.who.int/health-topics/infection-prevention-and-control#tab=tab_1.
24.	杨启文, 吴安华, 胡必杰, 等. 临床重要耐药菌感染传播防控策略专家共识. 中国感染控制杂志, 2021, 20(1): 1-14.
25.	马娟, 严晓华, 赵海, 等. 2018 年陕西省人民医院细菌耐药性监测. 中国感染与化疗杂志, 2020, 20(2): 195-201.
26.	全国细菌耐药监测网. 2014-2019 年细菌耐药性监测报告. 中国感染控制杂志, 2021, 20(1): 15-31.
27.	马爽, 张芸, 王世富, 等. 碳青霉烯类抗生素暴露对老年重症肺炎多重耐药菌检出率及预后的影响. 中国感染控制杂志, 2017, 16(11): 1056-1059.
28.	全国细菌耐药监测网. 2014-2019 年不同等级医院细菌耐药监测报告. 中国感染控制杂志, 2021, 20(2): 95-111.

1. 中华人民共和国卫生部. 卫生部办公厅关于印发《多重耐药菌医院感染预防与控制技术指南(试行)》的通知. 中华人民共和国卫生部公报, 2011(2): 59-61.
2. 胡付品, 郭燕, 朱德妹, 等. 2016 年中国 CHINET 细菌耐药性监测. 中国感染与化疗杂志, 2017, 17(5): 481-491.
3. 朱敬蕊, 崔琢, 汪振林, 等. 某三甲医院常见多重耐药菌流行趋势分析. 蚌埠医学院学报, 2020, 45(1): 94-97.
4. 陈国建, 杨洁, 邓艾, 等. 某综合医院常见多重耐药菌感染危险因素 logistic 回归分析. 华西医学, 2020, 35(3): 290-295.
5. 余佳佳, 李虎, 陶晓勤, 等. 2019 年上海交通大学医学院附属新华医院细菌耐药性监测. 中国抗生素杂志, 2021, 46(5): 442-449.
6. 蔡虻, 刘聚源. 多重耐药菌医院感染防控策略与思考. 中国护理管理, 2018, 18(12): 1590-1594.
7. 葛洁明, 范亚霞, 张文秋, 等. 2014-2018 年某三甲医院多重耐药菌的分布及趋势分析. 中国煤炭工业医学杂志, 2020, 23(3): 307-312.
8. 叶应妩, 王毓三, 申子瑜. 全国临床检验操作规程. 3 版. 南京: 东南大学出版社, 2006: 736-753.
9. 叶丹, 杨永红, 张婷, 等. 某医院下呼吸道感染分离菌分布及耐药性监测. 中国实验诊断学, 2020, 24(3): 386-389.
10. Clinical and Laboratory Standard Institute. M100-S23 Performance standards for antimicrobial susceptibility testing: twenty-third informational supplement: CLSI document M100-S23. Wayne, PA: Clinical and Laboratory Standard Institute, 2013.
11. 李春辉, 吴安华. MDR、XDR、PDR 多重耐药菌暂行标准定义—国际专家建议. 中国感染控制杂志, 2014, 13(1): 62-64.
12. 黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识. 中国感染控制杂志, 2015, 14(1): 1-9.
13. 中华人民共和国国家卫生和计划生育委员会. 国家卫生计生委办公厅关于印发麻醉等 6 个专业质控指标（2015 年版）的通知: 国卫办医函〔2015﹞252 号. (2015-03-31)[2022-02-01]. http://www.nhc.gov.cn/yzygj/s7657/201504/5fa7461c3d044cb6a93eb6cc6eece087.shtml.
14. 李六亿, 吴安华. 胡必杰. 如何提高医院感染预防与控制能力. 北京: 北京大学医学出版社, 2015: 190-215.
15. 国家卫生健康委. 国家卫生健康委关于印发三级医院评审标准（2020 年版）的通知: 国卫医发〔2020﹞26 号. (2020-12-21)[2022-02-01]. http://www.nhc.gov.cn/yzygj/s7657/202012/c46f97f475da4d60be21641559417aaf.shtml.
16. 国家卫生健康委医院管理研究所. 关于印发“提高住院患者抗菌药物治疗前病原学送检率”专项行动指导意见的函: 国卫医研函〔2021﹞198 号. (2021-10-28)[2022-02-01]. https://www.qiluhospital.com/uploadfile/2022/0120/20220120105510227.pdf.
17. 刘卫平, 焦月英, 海云婷, 等. 某医院多重耐药菌感染分布趋势与耐药性分析. 中国消毒学杂志, 2018, 35(12): 931-933, 936.
18. 张毅, 彭玲玲, 黄丽玲. 广东某军队医院 2019 年多重耐药菌检出现状及耐药性分析. 东南国防医药, 2021, 23(1): 45-49.
19. 林秀娟, 林红燕, 钟韵. 某三甲医院 2014-2016 年多重耐药菌感染趋势变迁. 广东医学, 2018, 39(1): 107-110.
20. National Center Emerging and Zoonotic Infectious Disease. Facility guidance for control of carbapenem-resistant Enterobacteriaceae (CRE). (2015-12-17)[2021-12-01]. http://www.cdc.gov/hai/pdfs/cre/CRE-guidance-508.pdf.
21. World Health Organization. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities. Geneva: World Health Organization, 2017. http://apps.who.int/iris/bitstream/10665/259462/1/9789241550178-eng.pdf?ua=1.
22. Tacconelli E, Cataldo MA, Dancer SJ, et al. ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients. Clin Microbiol Infect, 2014, 20(Suppl 1): 1-55.
23. World Health Organization. Infection prevention and control. [2022-03-03]. https://www.who.int/health-topics/infection-prevention-and-control#tab=tab_1.
24. 杨启文, 吴安华, 胡必杰, 等. 临床重要耐药菌感染传播防控策略专家共识. 中国感染控制杂志, 2021, 20(1): 1-14.
25. 马娟, 严晓华, 赵海, 等. 2018 年陕西省人民医院细菌耐药性监测. 中国感染与化疗杂志, 2020, 20(2): 195-201.
26. 全国细菌耐药监测网. 2014-2019 年细菌耐药性监测报告. 中国感染控制杂志, 2021, 20(1): 15-31.
27. 马爽, 张芸, 王世富, 等. 碳青霉烯类抗生素暴露对老年重症肺炎多重耐药菌检出率及预后的影响. 中国感染控制杂志, 2017, 16(11): 1056-1059.
28. 全国细菌耐药监测网. 2014-2019 年不同等级医院细菌耐药监测报告. 中国感染控制杂志, 2021, 20(2): 95-111.

West China Medical Journal

Changes of multidrug-resistant organisms in a tertiary general hospital around overall relocation

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