投稿分類 微生物

主委發表種類: 壁報

投稿標題(中): 十年來ㄧ地區教學醫院常見菌株的分佈趨勢與抗藥性情形之探討

投稿標題(英): To investigate the trend of common bacteria distribution and their antibiogram in ten-year period

投稿摘要: Background:
Chai-Yi Hospital is one public hospital which locates at Chia-Yi City. There are two roles of our routine business. One serves as medical institutions for medical and surgical patients and the other serves as community hospital. There are 66 long term care (LTC) facilities which make the contract with our hospital. We need to send staffs and afford medical service for these LTC regularly since 2015. Multi-drug resistant bacteria (MDR; including MRSA, CRE, CRAB, CRPA, VRE) of these patients are emerging increased in these years. So, we want to investigate the trend and antibiogram of common bacteria and the percentage of MDR pathogens in recent ten years.

Methods:
By way of Datong Cooperative System, we collect all of the isolated bacteria and divide them into two periods (A- Jan to Jun, B- Jul to Dec) year by year.
1. We select the period of 2011-2020 and divide each year to period A and B.
2. We select the common and important bacteria, as S. aureus, enterococci, E. coli, K.
pneumoniae, P. aeruginosa, A. baumannii.
3. We record the antibiogram of these bacteria to present antibiotics, as cephalosprin, penicillin,
aminoglycoside, quinolone, carbapenem, glycopeptides and others

Results:
1. There are 834 to 1,954 bacteria are enrolled in each period and the common pathogens account for 74.6 to 83.8%.
2. For the Gm(+) cocci, as S. aureus and enterococci:
(1) The percentage of MRSA account for 39.2 to 87.8%. It was still in high plateau.
(2) The percentage of VRE is different between E. faecalis and E. faecium. The former is 0 to 80.3% and the latter is 0 to 100%.
3. For the Gm(-) bacilli, as Enterobacteriaceae and NF-GNB [non-fermentative, Gm(-) bacilli]
(1) In Enterobacteriaceae, the percentage of CREC and CRKP are 0 to 2.7% and 0 to 34.6%.
(2) In NF-GNB, the percentage of CRPA and CRAB are 6.4 to 35% and 29.4 to 91.6%.

Conclusion:
1. Because of a high proportion of patients come from LTC, our cohort showed high percentage of MDR pathogens between these common bacteria. Some of them are closing the level of medical centers.
2. New listing novel antibiotics are limited and the severity of critical illness is continued to
increase. Multimodal approach of infection control and antibiotic stewardship are worth to
contain the trend.

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