Screening for multidrug resistant organisms in patients admitted to the 10 community hospitals

doi:10.3969/j.issn.1006-7795.2021.06.006

Journal of Capital Medical University ›› 2021, Vol. 42 ›› Issue (6): 936-942.doi: 10.3969/j.issn.1006-7795.2021.06.006

• Basic and Clinical Research in Critical Care Medicine • Previous Articles Next Articles

Screening for multidrug resistant organisms in patients admitted to the 10 community hospitals

Qian Fang^1,2, Jiang Li^3*, Liu Yongdong⁴, Huang Jing⁵, Ren Yanming⁶, Liu Yudong⁷, Li Emei⁸, Yuan Jing⁹, Pei Shuang¹⁰, Zhao Yan¹¹, Sun Wenxiu¹², Yu Liyan¹³, Zhang Xiaoping¹⁴, Zhang Xinmei², Wang Nan³

1. Comprehensive Intensive Care Medicine of the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China;
2. Department of Intensive Care Medicine, Fuxing Hospital, Capital Medical University, Beijing 100038, China;
3. Department of Intensive Care Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
4. Beijing Xicheng District Medical Institution Management and Service Center, Beijing 100032, China;
5. Department of Infection Management, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China;
6. Department of Nosocomiology, Zhanlan Road Hospital, Xicheng District, Beijing 100044, China;
7. Department of Nosocomiology,Beijing Xuanwu Hospital of Traditional Chinese Medicine, Beijing 100050, China;
8. Department of Nosocomiology, Beijing Anorectal Hospital, Beijing 100120, China;
9. Department of Nosocomiology, Huguosi Hospital affiliated to Beijing University of Chinese Medicine, Beijing 100035, China;
10. Department of Nosocomiology, Beijing Fengsheng Traditional Chinese Medicine Hospital, Beijing 100033, China;
11. Department of Nosocomiology, Beijing Xicheng District Pingan Hospital, Beijing 100055, China;
12. Department of Nosocomiology, Beijing Huimin Hospital, Beijing 100054, China;
13. Department of Nosocomiology, Guangwai Hospital, Xicheng District of Beijing, Beijing 100055, China;
14. Department of Nosocomiology, Beijing Second Hospital, Beijing 100031, China

Received:2021-09-10 Online:2021-12-21 Published:2021-12-17
Contact: * E-mail: jiangli@sina.com
Supported by:
Xicheng Sustainable Development Project(SD2015-13).

Abstract

Abstract: Objective To investigate the patient screening for multidrug-resistant organisms (MDROs) on admission to the 10 community hospitals in Beijing. Methods The patients admitted to the 10 community hospitals in Xicheng district were enrolled in the study from June 11, 2015 to September 30, 2016. The patients were divided into hospital group and community group according to the place before admission. Nasal swabs and anal swabs were collected within 48 hours after admission. Chromogenic culture medium technology was used to identify methicillin resistant staphylococcus aureus (MRSA), extended-spectrum β-lactamases (ESBL)-producing Enterobacteriaceae, and vancomycin resistant enterococcus (VRE). The positive percentage and distribution of the MDROs were compared between the groups. We also try to find risk factors for the positive MDROs. Results A total of 644 patients were enrolled in the study, among which 220 of the 304 patients in the hospital group showed positive screening at least one site, significantly higher than that of the 340 patients in community group (72.4% vs 51.5%, P<0.001). The positive percentage of nasal swab in hospital group was higher than that in the community group (11.8% vs 3.2%, P<0.001). The MRSA was the most found MDROs. The positive percentage of anal swab was higher than that of nasal swab in both groups. The patients with positive anal swab screening for 2 or more MDROs were significantly higher in the hospital group than that in the community group (18.9% vs 12.8%, P=0.046), especially with Escherichia coli (ECO) and Klebsiella-Enterobacter-Serratia-Citrobacter (KESC). Cerebrovascular disease, hypertension,surgery or interventional procedure, antibiotic exposure within 4 weeks prior to admission, and systemic inflammatory response syndrome (SIRS) on admission were risk factors for positive MDROs screening. Conclusion The positive MDROs screening were found in more than half of the patients admitted to the 10 community hospitals, especially, in patients transferred from tertiary hospital nearby. We should pay sufficient attention to these patients.

Key words: multidrug resistant organisms, screening, chromogenic medium, community referral, hospital referral

CLC Number:

R633

Qian Fang, Jiang Li, Liu Yongdong, Huang Jing, Ren Yanming, Liu Yudong, Li Emei, Yuan Jing, Pei Shuang, Zhao Yan, Sun Wenxiu, Yu Liyan, Zhang Xiaoping, Zhang Xinmei, Wang Nan. Screening for multidrug resistant organisms in patients admitted to the 10 community hospitals[J]. Journal of Capital Medical University, 2021, 42(6): 936-942.

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Screening for multidrug resistant organisms in patients admitted to the 10 community hospitals

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