Retrospective analysis of drug resistance characteristics and infection related risk factors of multidrug-resistant organisms (MDROs) isolated from the orthopedics department of a tertiary hospital

Abstract

Background Patients infected with multidrug-resistant organisms (MDROs) are known to exhibit longer hospital stays and a significantly poorer prognosis. We performed a 6-year retrospective analysis of nosocomial infections reported in the orthopedics department of our institution, to gain valuable insights into antibiotic sensitivity and infectivity characteristics of MDROs, in order to deduce effective measures to control the occurrence of multidrug-resistant infections in clinical practice. Methods All relevant data, including basic patient information, cultivated bacterial strains, and antimicrobial resistance, was obtained from the Hospital Information Warehouse. Results A total of 1392 strains of pathogenic bacteria were isolated; 358 belonged to MDROs (detection rate = 25.7%). All the isolated strains of MDROs were mostly from secretions (52.2%). The number of cases infected with MDROs were 144 (40.2%) and 129 (36.0%) in the trauma and spinal wards, respectively. MRSA showed high resistance to β lactam antibiotics, but was sensitive to quinolone antibiotics, linezolid and cotrimoxazole. ESBL-positive strains showed more sensitivity to carbapenem antibiotics (< 10%). MDR nonfermenters showed high resistance to most antibiotics. Logistic multivariate analysis revealed age, open injury, and central nervous system injury as independent risk factors for multidrug resistant infections. Conclusions A high antibiotic resistance rate and an increasing prevalence of infections with MDROs was identified in the orthopedics department. Patients with open injury, central nervous system injury and those aged ≥ 60 years, were more prone to multidrug-resistant infections. Clinicians should pay more attention to such patients in order to actively prevent and control the occurrence of infections caused by MDROs.