Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China
Background: To determine the distribution and antimicrobial susceptibility pattern of pathogenic bacteria in patients with chronic cutaneous wounds on a national scale.Methods: A retrospective study was conducted using the data recorded between January 1, 2018 and January1, 2020 in 195 hospitals acr...
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Frontiers Media S.A.
2021-03-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.609584/full |
| _version_ | 1819146355345457152 |
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| author | Haonan Guan Haonan Guan Wei Dong Wei Dong Yechen Lu Yechen Lu Minfei Jiang Minfei Jiang Di Zhang Di Zhang Yakupu Aobuliaximu Yakupu Aobuliaximu Jiaoyun Dong Jiaoyun Dong Yiwen Niu Yiwen Niu Yingkai Liu Yingkai Liu Bingjie Guan Jiajun Tang Jiajun Tang Shuliang Lu Shuliang Lu |
| author_facet | Haonan Guan Haonan Guan Wei Dong Wei Dong Yechen Lu Yechen Lu Minfei Jiang Minfei Jiang Di Zhang Di Zhang Yakupu Aobuliaximu Yakupu Aobuliaximu Jiaoyun Dong Jiaoyun Dong Yiwen Niu Yiwen Niu Yingkai Liu Yingkai Liu Bingjie Guan Jiajun Tang Jiajun Tang Shuliang Lu Shuliang Lu |
| author_sort | Haonan Guan |
| collection | DOAJ |
| description | Background: To determine the distribution and antimicrobial susceptibility pattern of pathogenic bacteria in patients with chronic cutaneous wounds on a national scale.Methods: A retrospective study was conducted using the data recorded between January 1, 2018 and January1, 2020 in 195 hospitals across China. After screening the data, 815 patients with chronic wounds were finally analyzed. The data collected included information about the patients' general condition and local cutaneous wound assessments, especially microbial culture and antibiotic susceptibility tests. The analyses were performed using SPSS Version 26.Results: The study included 815 patients (290 [35.6%] females; 63 [50–74] years). The most common causes of chronic cutaneous wounds were diabetes (183, 22.5%), infection (178, 21.8%), and pressure (140, 17.2%). Among these, 521(63.9%) samples tested yielded microbial growth, including 70 (13.4%) polymicrobial infection and 451 (86.6%) monomicrobial infection. The positive rate of microbial culture was highest in wound tissue of ulcers caused by infection (87.6%), followed by pressure (77.1%), diabetes (68.3%), and venous diseases (67.7%). Bates-Jensen wound assessment tool (BWAT) scores >25 and wounds that lasted for more than 3 months had a higher positive rate of microbial culture. BWAT scores >25 and wounds in the rump, perineum, and feet were more likely to exhibit polymicrobial infection. A total of 600 strains were isolated, of which 46.2% (277 strains) were Gram-positive bacteria, 51.3% (308 strains) were Gram-negative bacteria, and 2.5% (15 strains) were fungi. The most common bacterial isolates were Staphylococcus aureus (29.2%), Escherichia coli (11.5%), Pseudomonas aeruginosa (11.0%), Proteus mirabilis (8.0%), and Klebsiella pneumoniae (5.8%). The susceptibility tests showed that 116 cultured bacteria were Multidrug resistant (MDR) strains. The resistance rates of S. aureus were 92.0% (161/175) to penicillin, 58.3% (102/175) to erythromycin, and 50.9% (89/175) to clindamycin. Vancomycin was the most effective antibiotic (0% resistance rate) against all Gram-positive bacteria. Besides, the resistance rates of E. coli were 68.1% (47/69) to ampicillin, 68.1% (47/69) to ciprofloxacin, 60.9% (42/69) to levofloxacin. However, all the isolated Gram-negative bacteria showed low resistance rates to tigecycline (3.9%) and amikacin (3.6%).Conclusions: The distribution of bacteria isolated from chronic cutaneous wounds varies with the BWAT scores, causes, duration, and the location of wounds. Multidrug resistance is a serious health issue, and therefore antibiotics used in chronic wounds must be under strict regulation. Our findings may help clinicians in making informed decisions regarding antibiotic therapy. |
| first_indexed | 2024-12-22T13:12:36Z |
| format | Article |
| id | doaj.art-aac460dcb32943ed8f6e6268bddfa0ff |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-22T13:12:36Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-aac460dcb32943ed8f6e6268bddfa0ff2022-12-21T18:24:43ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-03-01810.3389/fmed.2021.609584609584Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in ChinaHaonan Guan0Haonan Guan1Wei Dong2Wei Dong3Yechen Lu4Yechen Lu5Minfei Jiang6Minfei Jiang7Di Zhang8Di Zhang9Yakupu Aobuliaximu10Yakupu Aobuliaximu11Jiaoyun Dong12Jiaoyun Dong13Yiwen Niu14Yiwen Niu15Yingkai Liu16Yingkai Liu17Bingjie Guan18Jiajun Tang19Jiajun Tang20Shuliang Lu21Shuliang Lu22Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of General Surgery, School of Medicine, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaWound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, ChinaBackground: To determine the distribution and antimicrobial susceptibility pattern of pathogenic bacteria in patients with chronic cutaneous wounds on a national scale.Methods: A retrospective study was conducted using the data recorded between January 1, 2018 and January1, 2020 in 195 hospitals across China. After screening the data, 815 patients with chronic wounds were finally analyzed. The data collected included information about the patients' general condition and local cutaneous wound assessments, especially microbial culture and antibiotic susceptibility tests. The analyses were performed using SPSS Version 26.Results: The study included 815 patients (290 [35.6%] females; 63 [50–74] years). The most common causes of chronic cutaneous wounds were diabetes (183, 22.5%), infection (178, 21.8%), and pressure (140, 17.2%). Among these, 521(63.9%) samples tested yielded microbial growth, including 70 (13.4%) polymicrobial infection and 451 (86.6%) monomicrobial infection. The positive rate of microbial culture was highest in wound tissue of ulcers caused by infection (87.6%), followed by pressure (77.1%), diabetes (68.3%), and venous diseases (67.7%). Bates-Jensen wound assessment tool (BWAT) scores >25 and wounds that lasted for more than 3 months had a higher positive rate of microbial culture. BWAT scores >25 and wounds in the rump, perineum, and feet were more likely to exhibit polymicrobial infection. A total of 600 strains were isolated, of which 46.2% (277 strains) were Gram-positive bacteria, 51.3% (308 strains) were Gram-negative bacteria, and 2.5% (15 strains) were fungi. The most common bacterial isolates were Staphylococcus aureus (29.2%), Escherichia coli (11.5%), Pseudomonas aeruginosa (11.0%), Proteus mirabilis (8.0%), and Klebsiella pneumoniae (5.8%). The susceptibility tests showed that 116 cultured bacteria were Multidrug resistant (MDR) strains. The resistance rates of S. aureus were 92.0% (161/175) to penicillin, 58.3% (102/175) to erythromycin, and 50.9% (89/175) to clindamycin. Vancomycin was the most effective antibiotic (0% resistance rate) against all Gram-positive bacteria. Besides, the resistance rates of E. coli were 68.1% (47/69) to ampicillin, 68.1% (47/69) to ciprofloxacin, 60.9% (42/69) to levofloxacin. However, all the isolated Gram-negative bacteria showed low resistance rates to tigecycline (3.9%) and amikacin (3.6%).Conclusions: The distribution of bacteria isolated from chronic cutaneous wounds varies with the BWAT scores, causes, duration, and the location of wounds. Multidrug resistance is a serious health issue, and therefore antibiotics used in chronic wounds must be under strict regulation. Our findings may help clinicians in making informed decisions regarding antibiotic therapy.https://www.frontiersin.org/articles/10.3389/fmed.2021.609584/fullpathogenbacteria distributionantibiotic resistancemulti drug resistantchronic wounds |
| spellingShingle | Haonan Guan Haonan Guan Wei Dong Wei Dong Yechen Lu Yechen Lu Minfei Jiang Minfei Jiang Di Zhang Di Zhang Yakupu Aobuliaximu Yakupu Aobuliaximu Jiaoyun Dong Jiaoyun Dong Yiwen Niu Yiwen Niu Yingkai Liu Yingkai Liu Bingjie Guan Jiajun Tang Jiajun Tang Shuliang Lu Shuliang Lu Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China Frontiers in Medicine pathogen bacteria distribution antibiotic resistance multi drug resistant chronic wounds |
| title | Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China |
| title_full | Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China |
| title_fullStr | Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China |
| title_full_unstemmed | Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China |
| title_short | Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China |
| title_sort | distribution and antibiotic resistance patterns of pathogenic bacteria in patients with chronic cutaneous wounds in china |
| topic | pathogen bacteria distribution antibiotic resistance multi drug resistant chronic wounds |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.609584/full |
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