Current Situation Of Multidrug-Resistant Bacteria Infection In Trauma Center Of A Third Class A Hospital

Objective: To analyze the distribution of MDRO in the trauma center ward of our hospital and explore the risk factors of MDRO,select10 strains for bacterial frame sequencing,and carry out structural prediction and functional annotation of the genome.To strengthen clinicians’ understanding of the current situation of bacterial drug resistance in trauma centers.Method: Collate medical records of hospitalized patients whose multidrug-resistant bacteria were detected at the trauma center.Data from orthopedic trauma and emergency surgical units from January 2017 to December 2022 were retrospectively analyzed.Multidrug-resistant bacteria infect patients in the orthopaedic trauma ward and emergency surgical ward were selected as the study group(97 cases in the orthopaedic trauma ward and 34 cases in the emergency surgical ward).The gender and age distribution of patients were analyzed,and the composition of MDRO strain and the source of samples were statistically analyzed,sort out the drug sensitivity test results of bacteria,compare general information on Gram-positive and Gram-negative bacteria in the MDRO and analyze bacterial resistance to various antibiotics.Ten strains were selected for bacterial framework sequencing.Result: 1.Distribution: Staphylococcus aureus(35.17%),Escherichia coli(28.97%),Acinetobacter baumannii(19.31%),Klebsiella pneumoniae(13.79%),Pseudomonas aeruginosa(2.07%),and Enterobacter cloacae(0.69%).2.Source and distribution of samples:secretion(57.93%),pus(16.55%).Staphylococcus aureus and Escherichia coli were the most common strains cultured from secretions and pus.Sputum specimens(14.48%)were mostly Klebsiella pneumoniae.Urine specimen(8.97%),blood specimen(1.38%),tissue specimen(0.69%).3.Divide the bacteria into two groups: gram-positive bacteria group and the gram-negative.Comparison of general information of the different group in patients with MDRO infection: In statistics,there were differences between the two groups in whether to use a ventilator,whether to place a tube,length of stay,and whether to have an ICU treatment history(P< 0.05),while in hypertension,age ≥ 60 years,diabetes,gender,arteriovenous catheterization,and surgical history,there were no statistically significant differences(P> 0.05).4.MRSA＿1 carried31 antibiotic resistance genes,and MRSA＿2 carried 32 antibiotic resistance genes.Conclusions: 1.The main bacteria infected with MDRO in trauma center ward is MRSA.2.Trauma center MDRO specimens are mainly derived from secretions.3.In a trauma center MDRO infection,there are differences between two groups bacteria in terms of length of stay,ventilator use,indent catheterization,and ICU treatment history,however,there was no significant difference in hypertension,age greater than or equal to 60,diabetes,gender,arteriovenous catheterization,surgical history,etc.4.The average length of genome was 2,761,289 bp and the average content of GC was 32.7% in MRSA＿1-10.