Screening and drug resistance analysis of multidrug-resistant bacteria in neonatal intensive care unit

Abstract

Objective To provide a scientific basis for the prevention and control of the spread of multidrug-resistant bacteria in hospital and the rational clinical use of drugs by investigating and analyzing the colonization status and drug resistance characteristics of multidrug-resistant bacteria in the neonatal intensive care unit (NICU). Methods Bacterial culture and drug sensitivity test were carried out on 176 anal swabs in NICU hospitalized patients at Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital from May 1 to October 31 2018. Swabs were collected within one hour of admission for sterile screening. Drug resistance analysis was carried out on patients whose screening result was positive, to know bacterial colonization and resistance in patients admitted to the NICU. The results of bacterial culture and the rate of bacterial isolation in children of different ages were compared by the χ2 test. Results Multiple drug-resistant bacteria were detected in 23 children's specimens, and the colonization rate of multidrug-resistant bacteria was 13.1%. The positive rate of multiple drug-resistant bacteria in newborns < 3 d was lower than that of newborns 3~28 d (χ2=4.099, P=0.043). Of the 23 strains of multidrug-resistant bacteria detected, 11 were extended-spectrum β lactamases (ESBLs)-producing bacteria, 10 were vancomycin-resistant Enterococcus (VRE), and 2 were methicillin-resistant Staphylococcus aureus (MRSA). The resistance rate of 11 strains of ESBLs-producing bacteria to ampicillin, piperazine, cefazolin, cefuroxime, ceftriaxone, and gentamicin was 100%. The resistance rate of 10 strains of VRE to vancomycin, penicillin, and ampicillin was also 100%, while they were completely sensitive to tekelanin and linezolid. The two strains of MRSA were completely sensitive to vancomycin, tekelanin, and linezolid, but were completely resistant to penicillin, cephalosporins, and erythromycin. Conclusion The colonization rate of multidrug-resistant bacteria is high among children in NICU and the drug resistance is serious. Attention should be paid to the screening of multiple drug-resistant organisms in neonates aged ≥ 3 d and monitoring should be strengthened to avoid the outbreak of multidrug-resistant bacteria in hospitals. Key words: Neonatal intensive care unit; Multiple drug-resistant bacteria; Bacterial colonization; Drug resistance