In this study, we analysed bacterial drug resistance in our hospital from 2022 Q1 to 2023 Q2. The most common Gram-positive bacteria detected in this study was S. aureus, followed by E. faecalis, S. epidermidis, and S. haemolyticus. No VR strains were detected, suggesting that vancomycin may be clinically indicated for the treatment of severe infections in MRSA and MR coagulase-negative Staphylococcus. The top three Gram-negative bacteria detected were E. coli, K. pneumoniae, and P. aeruginosa. Based on the monitored data, Enterobacterales bacteria still had a high sensitivity rate (> 90.0%) to carbapenem antimicrobial drugs; however, it remains a primary factor in causing severe patient infections. The data also showed that P. aeruginosa still has a high sensitivity rate (> 85.0%) to aminoglycoside antimicrobial drugs.

Multidrug-resistant bacteria were mainly found in respiratory specimens such as sputum (> 50%), which is consistent with reports in the literature [18, 19]. This may be related to the clinical practice of distributing samples, among which respiratory specimens accounted for about 50% of all specimens sent for testing. There is much controversy about the clinical value of bacterial cultures of sputum specimens, and the resistance rate of respiratory colonisers is generally higher than that of probable pathogens [20]; additionally, the number and proportion of MDR bacteria among the actual pathogens have yet to be confirmed. The second most common sample with bacteria detection is mid-stream urine and secretions, which is mainly related to the fact that clinical urinary tract infection pathogens are dominated by E. coli (ESBL-positive strains are numerous). Additionally, in secretion-infected specimens, the MRSA infection rate is relatively high, and contact with hospital-acquired MRSA carriers can increase the risk of MRSA colonisation [21], a factor that should be addressed in clinical settings. The spread of MRSA can be effectively controlled through a series of measures, such as strengthening MRSA screening and monitoring, and the timely isolation of patients with MRSA infections [22]. The isolation of bacterial strains from sterile bodily fluids such as blood has definite clinical significance; however, the proportion of MDR bacteria among these strains is much lower compared with the above-noted specimens, the reason for which is still unknown and requires further study and analysis.

The findings of our study are consistent with existing research that reported high prevalence and resistance rates for S. aureus, E. coli, K. pneumoniae, and P. aeruginosa in clinical settings [23,24,25]. These bacteria are known to cause various infections, such as skin and soft tissue infections, urinary tract infections, bloodstream infections, and respiratory infections, and pose a serious threat to public health [26]. The emergence and spread of MDR strains of these bacteria have reduced the treatment options and increased the morbidity and mortality of infected patients. Antimicrobial resistance surveillance studies are essential for providing timely and accurate information on the epidemiology and trends among resistant bacteria, thereby guiding the clinical diagnosis and treatment of infections, evaluating the effectiveness of infection prevention and control measures, and informing policymaking and resource allocation for antimicrobial stewardship programmes [27]. However, the quality and comprehensiveness of surveillance data can be affected by various factors, such as a lack of data on patient characteristics, clinical outcomes, and molecular mechanisms of resistance [28]. A comparative study on the changes of bacterial species and resistance rates to commonly used antibacterial drugs approximately 13 years ago showed that the resistance rates of the main Gram-positive cocci to commonly used antibacterial drugs have increased significantly over time [29]. Another study on the prevalence and drug resistance patterns of Gram-negative bacteria in a tertiary care hospital in India reported high resistance rates to commonly used antibiotics such as ceftriaxone, ciprofloxacin, amikacin, and piperacillin–tazobactam [30].

Isolation measures have been proposed to prevent ESBL infection, primarily active surveillance, the isolation of all patients infected with ESBL, contact prophylaxis for all colonised or infected patients, and the rational management of antimicrobial drugs [31]. A significant increase was found in the detection rate of ESBL bacilli, from 0.28 to 0.67‰ (P < 0.001) in admitted patients during this period, but the increase in the rate of nosocomial infection with ESBL was not high, suggesting that the infection control measures had a role in controlling the nosocomial transmission. Hassoun et al. [32] achieved a significant improvement in the detection rate of ESBL bacilli from 0.28 to 0.67‰ (P < 0.001) among patients over 2 years through a series of MRSA control measures. The incidence of MRSA hospital-acquired infections among inpatients decreased from 0.7/1000 hospital days in the first quarter of 2007 to 0.29/1000 hospital days in the fourth quarter of 2008 (P = 0.05), showing a 59% reduction in the transmission of MRSA hospital-acquired infections. The existing literature and relevant national regulations and guidelines indicate that hospital infections can be effectively prevented and controlled through, for example, the adoption of targeted surveillance, strict hand hygiene measures, disinfection and isolation, the education of medical staff, and effective supervision. However, to achieve good results, not only one department or one method can be implemented; rather, the cooperation of all hospital departments, collaboration among the various personnel, and the application of multiple methods should be adopted [33].

This study has some limitations, such as a lack of data on patient characteristics, clinical outcomes, and molecular mechanisms of resistance. Future studies should address these gaps and improve the quality and comprehensiveness of surveillance data.