Abstract
Background: Antimicrobial resistance (AMR) is an issue not only with regard to public health, but also in terms of economic impact. AMR surveillance has mainly been carried out in general hospitals, and not in nursing hospitals. This study was conducted to investigate the AMR rate for bacterial strains isolated from nursing hospital samples.Methods: Antimicrobial susceptibility testing (AST) results from a total of 23,518 bacterial isolates recovered from clinical specimens taken in 61 nursing hosals were analyzed. AST was conducted using Vitek 2 with AST cards specific for the bacterial strains.Results: A total of 19,357 Gram-negative and 4,161 Gram-positive bacterial strains were isolated. Pseudomonas aeruginosa (n=6,384) and Escherichia coli (n=5,468) were the most prevalent bacterial species and, among Gram-positive bacteria, Staphylococcus aureus (n=1,565) was common. The AMR rate was high for the following strains: cefotaxime-resistant Klebsiella pneumoniae, 77.4%; cefotaxime-resistant E. coli, 70.6%; imipenem-resistant Acinetobacter baumannii, 90.3%; imipenem-resistant P. aeruginosa, 49.3%; oxacillin- resistant S. aureus, 81.1%, penicillin-resistant Enterococcus faecalis, 44.8%, and vancomycin-resistant Enterococcus faecium, 53.5%. AMR rate change varied by bacterial species and antimicrobial drug.Conclusion: AMR rates of major pathogens from nursing hospitals were higher than those from general hospitals with the exception of imipenem-resistant A. baumannii. Continuous monitoring and infection control strategies are needed. (Ann Clin Microbiol 2019;22:96-104)
Keywords
Antimicrobial resistance Nursing hospital Surveillance study
Figures & Tables
Fig. 1. Participating nursing hospitals in this study. Numbers of nursing hospitals are indicated in parentheses after the name of each district.
Figures & Tables
Table 1. Patients included in the study
| Species | Total | Sex | ||
| Male | Female | Unknown | ||
| 5,468 (23.3%) | 1,129 (27.8%) | 2,934 (72.2%) | 1,405 | |
| 3,346 (14.2%) | 1,338 (52.4%) | 1,216 (47.6%) | 769 | |
| 2,885 (12.3%) | 1,433 (63.8%) | 812 (36.2%) | 640 | |
| 6,384 (27.1%) | 2,955 (58.9%) | 2,061 (41.1%) | 1,368 | |
| Other Gram-negatives* | 1,274 (5.4%) | 574 (57.1%) | 431 (42.9%) | 269 |
| 1,565 (6.7%) | 650 (49.6%) | 660 (50.4%) | 255 | |
| 564 (2.4%) | 160 (37.4%) | 268 (62.6%) | 136 | |
| 776 (3.3%) | 225 (35.3%) | 413 (64.7%) | 138 | |
| Other Gram-positives† | 1,256 (5.3%) | 530 (50.3%) | 23 (49.7%) | 203 |
| Total | 23,518 (100%) | 8,994 (49.1%) | 9,318 (50.9%) | 5,183 |
