-Original-

Evaluation of Resistance by Clinically Pathogenic Bacteria to Antimicrobials and Common Disinfectants in Beijing, China

Kai Shan¹, Jianguo Li¹, Weihai Yao², Jie Li³, Xinhua He⁴, Fengjie Li⁵, Wei Wen⁶, Qingyu Liu⁷ and Wei Guo¹

¹Department of Emergency Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
²Department of Emergency Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
³Department of Emergency Medicine, Fuxing Hospital, Capital Medical University, Beijing, China
⁴Department of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
⁵Department of Emergency Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
⁶Department of Emergency Medicine, Beijing Hospital, Beijing, China
⁷Department of Emergency Medicine, People's Hospital of Daxing District, Beijing, China

Background: Antibiotic resistance of pathogenic bacteria is well recognized among clinicians; however, studies that directly evaluate the bacterial resistance to commonly used disinfectants in clinical settings are lacking. Currently available reports focus on the resistance of single strains to single disinfectants and do not adequately examine the degree of resistance and cross-resistance to antimicrobials in the large-scale clinical use of disinfectants.
Methods: We investigated the resistance capacity to 11 antibiotics and 7 chemical disinfectants by bacterial strains collected from body fluids of patients in 10 hospitals in Beijing, China over a 1-year period. Bacterial resistance to disinfectants was tested using minimum inhibitory concentration and minimum bactericidal concentration using agar dilution methods based on commercially available reference strains.
Results: A total of 1,104 pathogenic strains were identified, of which 23% were Gram-positive bacteria, 74% were Gram-negative bacteria, and 3% were fungi. Overall, resistance to antibiotics for the most common strains was significantly higher than their resistance to disinfectants. The least effective antibiotics and disinfectants were aztreonam and glutaral, respectively, exhibiting the highest overall resistance rates; while amikacin and alcohol had the lowest resistance rates. Consistently, Acinetobacter baumannii exhibited the most resistance, while Escherichia coli had the least resistance for both antibiotics and disinfectants.
Conclusions: Based on the pathogen spectrum for bacterial infective pathogens evaluated in this study, as well as the status quo of their resistance to antimicrobial agents and common clinical disinfectants, it is essential for healthcare professionals to pay attention not only to the standardized use of antimicrobial agents but also to the rational application of disinfectants.

J Nippon Med Sch 2018; 85: 302-308

Keywords
antimicrobials, clinical surveillance, drug resistance, hospital isolates, pathogenic bacteria

Correspondence to
Wei Guo, MD, Department of Emergency Medicine, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili Number 8, Dongcheng district, Beijing 100050, The People's Republic of China
guowei1010@126.com

Received, January 11, 2018
Accepted, July 6, 2018