To investigate the distribution characteristics and antimicrobial resistance of multidrug-resistant organism, and provide evidence for clinical rational use of antimicrobial agents.

The multidrug resistant bacterial spectrum and results of drug sensitivity test of 306 patients with multidrug-resistant infection in urology in the Sixth Affliliated Hospital of Sun Yat-sen University from January, 2016 to December, 2020 were retrospectively analyzed, including the number of multi-drug resistant bacteria, the types of multi-drug resistant bacteria, the distribution of submitted samples, and the drug sensitivity of multi-drug resistant bacteria. Case mix index (CMI) and defined daily dose(DDD) of the Department of Urology in our hospital from 2016 to 2020 were further discussed.

A total of 306 cases of multi-drug resistant bacteria were detected. The number of drug-resistant bacteria in each year was 32, 53, 64, 111 and 46, respectively, and the detection rates were 11.1%, 7.5%, 10.1%, 9.1% and 4.2%, respectively. After comparison, the detection rate of multi-drug resistant bacteria in 2020 was significantly reduced, with statistical significance. In terms of the distribution of multi-drug resistant bacterial diseases, 99 cases (32.4%) were urinary calculi, 47 cases (15.4%) of urinary tract infection; 44 cases (14.4%) were urinary system tumors. In terms of the distribution of drug-resistant bacterial samples, 268 cases (87.6%) were midstream urine samples and 14 cases (4.6%) were blood samples.The top three multidrug-resistant bacteria were 223 cases (72.9%) of Escherichia coli, 43 cases (14.1%) of Klebsiella pneumoniae, and 19 cases (6.2%) of coagulase-negative staphylococci.Further drug resistance analysis showed that the antibacterial drugs with high drug resistance in large intestine were ceftazidime 69.10%, cefepime 65.00%, and ciprofloxacin 43.90%, respectively, and the antibacterial drugs with high drug resistance in Klebsiella pneumoniae were ceftazidime 60.50%, cefepime 55.80%, and ampicillin 41.90%.The drug sensitivity results of coagulase negative staphylococci showed that they were resistant to penicillin and oxacillin, 80% to gentamicin and levofloxacin, and 62.5% to cotrimoxazole.

The CMI of urology department in our hospital increased year by year from 2016 to 2020. Under the condition of stable fluctuation of DDD, the number of multiple resistant bacteria in our hospital decreased significantly in 2020, suggesting that strengthening the supervision of hospital sensation and strictly implementing the management measures of multiple resistant bacteria play an important role in the control of multiple resistant bacteria. Further analysis of multi-drug resistant bacteria showed that in recent 5 years, multi-drug resistant bacteria, negative bacteria were mainly Escherichia coli, Klebsiella pneumoniae, positive bacteria were mainly coagulase-negative staphylococci, the distribution and drug resistance of urological pathogens should be monitored regularly to guide the rational use of antibacterial drugs in clinical practice.