Abstract
BackgroundGram-positive bacteria are dangerous and challenging agents of infection due to their increasing resistance to antibiotics. We aim to analyse the epidemiology and risk factors of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) in Zhejiang China.MethodsGram-positive bacteria (including S. aureus, Enterococcus faecalis and Enterococcus faecium) were collected from eighty-six hospitals of eleven cities in Zhejiang China from 2015 to 2017. The detection rates of MRSA and VRE infection were calculated for the non-duplicated isolate according to year, region, hospital level, patient age, specimen type and patient category. Meanwhile, the detected resistances of MRSA, E. faecalis and E. faecium to different antibiotics from 2015 to 2017 were compared. The risk factors and the differences in MRSA and VRE detection rates were compared using odds ratio (OR) with 95% confidence interval (95% CI) and Chi-square test respectively.ResultsFrom 2015 to 2017, the detection rates of MRSA and VRE decreased gradually. The cities with the highest MRSA and VRE detection rates tended to be adjacent; for example, the neighbouring cities Hangzhou and Quzhou had simultaneously high rates of MRSA and VRE infection. Patients from IIIA hospital who were older than 75 years and in the intensive care unit (ICU) were most at risk. No vancomycin-resistant isolate was found in MRSA. Resistance of E. faecalis and E. faecium to vancomycin and linezolid decreased slightly and then maintained a low level.ConclusionsThe detection rates of MRSA and VRE stayed at moderate and low levels during the three year period of this study, while local dissemination was found in MRSA and VRE isolates. Sustained surveillance is necessary to prevent the spread or clonal dissemination of drug-resistant strains in Zhejiang China.
Highlights
Gram-positive bacteria are dangerous and challenging agents of infection due to their increasing resistance to antibiotics
Antimicrobial resistances of Gram-positive bacteria have been reported in many countries [7,8,9]; it was only in recent years that vanM-carrying E. faecalis strains were isolated from patients and the clinical environment in the Second Affiliated Hospital of Zhejiang University School of Medicine [10], we speculate that if vanM infection has been spreading in the Zhejiang province, it may lead to an increase of vancomycin-resistant enterococci (VRE) overall
This high number of isolates may be due to Hangzhou having more IIIA hospitals, which were the contributors of 67% of all methicillin-resistant Staphylococcus aureus (MRSA) and enterococci isolates
Summary
Gram-positive bacteria are dangerous and challenging agents of infection due to their increasing resistance to antibiotics. Gram-positive bacteria, such as Staphylococcus aureus, Enterococcus faecalis, and Enterococcus faecium are dangerous and challenging agents of infection due to their increasing resistance to antibiotics [1]. Enterococci (including E. faecalis and E. faecium) are the second frequently isolated Gram-positive bacteria at 19.5%. Antimicrobial resistances of Gram-positive bacteria have been reported in many countries [7,8,9]; it was only in recent years that vanM-carrying E. faecalis strains were isolated from patients and the clinical environment in the Second Affiliated Hospital of Zhejiang University School of Medicine [10], we speculate that if vanM infection has been spreading in the Zhejiang province, it may lead to an increase of VRE overall.
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