OBJECTIVE To monitor the distribution and drug resistance of multidrug-resistant organism (MDRO) in the emergency department of a hospital from 2015 to 2024, providing reference for the prevention and control of drug-resistant organism in the hospital.
METHODS Clinical data of 7 911 patients with MDRO detected in sputum, blood, urine and other specimens from the Emergency Department of the First Medical Center of PLA General Hospital from Jan. 1, 2015 to Dec. 31, 2024 were collected. The basic characteristics of infected patients and MDRO resistance profiles were analyzed.
RESULTS Among 7 911 patients, 1 533 strains of MDROs were detected. The top three were multidrug-resistant Acinetobacter baumannii (MDR-AB) (54.21%), carbapenem-resistant Enterobacteriaceae (CRE) (27.27%) and multidrug-resistant Pseudomonas aeruginosa (8.41%). The detection rate of MDR-AB in community-associated infection was higher than in hospital-associated infection, while CRE was more frequently detected in hospital-associated infection. The primary infection sites were the lower respiratory tract (69.54%) and bloodstream (10.18%). Sputum was the most common specimen, followed by blood and urine. MDRO detection rates in sputum and drainage fluid were higher in community-associated infection, predominantly MDR-AB, whereas blood and urine specimens showed higher MDRO detection in hospital-associated infection, mainly CRE. Some bacterial strains remained relatively high susceptibility to certain antibacterial agents, providing a basis for rational and standardized clinical antibacterial agent use.
CONCLUSIONS The incidence of MDRO infection in the emergency department, both hospital- and community-associated, is high. Rational antibacterial agent use should be guided by the distribution characteristics of organism detected in specimens from different sites and drug resistance surveillance results.
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