Situation of Patients Infected with 8 Types of Antimicrobial-Resistant Bacteria in the Bloodstream in Nong Khai Hospital

Abstract

Bloodstream infections are a condition caused by bacterial infections in the bloodstream, which can lead to inflammation and organ failure if not treated promptly. The problem of antimicrobial resistance is a significant barrier that reduces the effectiveness of infection treatments. In Thailand, the trend of antibiotic-resistant bacterial infections continues to rise. The objective of this study is to investigate the rate and incidence of infection, antimicrobial resistance, and trends in infections caused by 8 types of drug-resistant bacteria in the bloodstream of patients at Nong Khai Hospital. The study design is descriptive and focuses on inpatients who received treatment at Nong Khai Hospital between January 1, 2023, and December 31, 2024, and had bacterial cultures isolated from their bloodstream. Data analysis was conducted using the AMASS program, descriptive statistics, and inferential statistics (Chi-square test; p < 0.05). The study found that the rate of patients with antibiotic-resistant bacterial infections decreased from 29.25% to 25.00%, with statistical significance (P-value < 0.001). The rate of hospital-acquired infections decreased from 41.18% to 27.40%, but there was no statistically significant difference (P-value = 0.060). Meanwhile, the rate of community-acquired infections increased from 58.82% to 72.60%, with statistical significance (P-value = 0.022). However, the incidence of infections in patients decreased from 5,378 to 2,615 cases. For antimicrobial resistance, the resistance to carbapenem drugs in Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa showed a tendency to decrease and increase, but no statistically significant difference was found (P-value > 0.05). On the other hand, Escherichia coli showed a tendency to increase, which was statistically significant (P-value = 0.043). Additionally, the resistance to 3^rd generation cephalosporins in K. pneumoniae and E. coli showed an increasing trend, but there was no statistically significant difference (P-value > 0.05). Overall, E. coli was the most commonly found pathogen, and A. baumannii showed a tendency to increase, while K. pneumoniae showed a tendency to decrease. Other pathogens showed no clear changes. Based on the results of this study, it is recommended to continuously monitor the trends of bacterial antimicrobial resistance, improve infection control measures in hospitals, enhance knowledge among healthcare personnel and the public, and promote the proper use of antibiotics to slow down and reduce the problem of antimicrobial resistance in the future.