Distribution and drug resistance of pathogenic bacteria isolated from hepatobiliary surgery department patients with nosocomial infection from 2011 to 2020

OBJECTIVE To explore the distribution and drug resistance changes of the main pathogenic bacteria related to nosocomial infection in Hepatobiliary Surgery, and to provide theoretical basis for the rational selection of antibiotics for the treatment of nosocomial infection in hepatobiliary surgery. METHODS Inpatients with nosocomial infection in the Department of Hepatobiliary Surgery in a hospital from 2011 to 2020 were recruited, the clinical data were collected, and the composition of pathogenic bacteria detected in different nosocomial infection types and drug resistance of main pathogenic bacteria were analyzed retrospectively. RESULTS From 2011 to 2020, total of 65001 inpatients were admitted to the Department of Hepatobiliary Surgery, and nosocomial infection occurred in 3525 patients. The highest incidence occurred in surgical site infection（SSI）（1.97%） followed by bloodstream infection（BSI）（1.48%） and lower respiratory tract infection（0.81%）. A total of 4551 strains of bacteria were isolated, including 2796 strains（61.44%） of gram-negative bacteria, 1080 strains（23.73%） of gram-positive bacteria and 675 strains（14.83%） of fungi. Gram-negative bacteria mainly included Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Acinetobacter baumannii. Enterococcus faecium was the most common gram-positive bacteria. K. pneumoniae was the primary pathogen in SSI and BSI infections, and A. baumannii was the primary pathogen in lower respiratory tract infection. The detection rates of E. coli and P. aeruginosa showed a downward trend in recent ten years（P＜0.05）. The drug-resistant rate of K. pneumoniae to imipenem increased from 18.75% in 2011 to 75.89% in 2020, showing a significant upward trend（P＜0.001）. CONCLUSION SSI is the main type of nosocomial infection in Hepatobiliary Surgery Department, and different infection sites have different pathogens. The main pathogens are Gram-negative bacteria, and carbapenem-resistant strains are common. The trend of carbapenem-resistant K. pneumoniae infection has been increasing year by year in the past decade, which calls for the solid prevention and control measures to the nosocomial infection resistant bacteria in hepatobiliary surgery department, and rational use of antibacterial drugs.