Pseudomonas aeruginosa prevalence, antibiotic resistance and antimicrobial use in Chinese burn wards from 2007 to 2014

Abstract

Objective To assess the application of antibacterial agents, alongside pathogen prevalence and Pseudomonas aeruginosa drug resistance, with the aim of understanding the impact of inappropriate antibacterial use. Methods This retrospective study assessed bacteria from wounds, catheters, blood, faeces, urine and sputum of hospitalized patients in burn wards between 2007 and 2014. The intensity of use of antibacterial agents and resistance of P. aeruginosa to common anti-Gram-negative antibiotics were measured. Results Annual detection rates of Staphylococcus aureus were significantly decreased, whereas annual detection rates of P. aeruginosa and Klebsiella pneumoniae were significantly increased. Multidrug-resistant strains of P. aeruginosa were increased. The intensity of use of some anti-Gramnegative antibiotics positively correlated with resistance rates of P. aeruginosa to similar antimicrobials. Conclusion In burn wards, more attention should be paid to P. aeruginosa and K. pneumoniae. The use of ciprofloxacin, ceftazidime and cefoperazone/sulbactam should be limited to counter the related increase in resistance levels.

Keywords: Burn; Pseudomonas aeruginosa; antibacterial agents; antibiotic; antimicrobial; drug resistance.

Figure 1.

Annual changes in the percentage of specific bacteria among all detected pathogens from 2007 to 2014. Purple lines represent Gram-positive bacteria, red lines represent Gram-negative bacteria. Dark colours indicate significant changes in trends, and light colours indicate non-significant changes in trends.

Figure 2.

Annual changes in antibacterial use density (defined daily doses/1000 patient-days, DDDs/1000 PD) from 2007 to 2014. Purple lines represent antibiotics commonly used against Gram-positive bacteria; red lines represent antibiotics used against Gram-negative bacteria; green lines represent antibiotics with antibacterial activity against both Gram-positive and Gram-negative bacteria. Dark colours (bottom panel) indicate significant changes in trends, light colours (upper and middle panels) indicate non-significant changes in trends.

Figure 3.

Annual changes in the percentage of P. aeruginosa resistant to specific antibiotics from 2007 to 2014. The percentage (%) of P. aeruginosa resistant to specific antibiotics was measured by the Kirby–Bauer disk diffusion method. Red lines represent antibiotics commonly used against Gram-negative bacteria, green lines represent antibiotics with antibacterial activities against both Gram-positive and Gram-negative bacteria. Dark colors indicate significant changes in trends, light colors indicate non-significant changes in trends.