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Volume 42, Number 5, October 2009

High prevalence rate of multidrug resistance among nosocomial pathogens in the respiratory care center of a tertiary hospital

Chun-Ming Lee, Shu-Chen Yeh, Hwee-Kheng Lim, Chang-Pan Liu,Hsiang-Kuang Tseng

Received: August 18, 2008    Revised: September 1, 2008    Accepted: September 13, 2008   


Corresponding author:

Dr. Chun-Ming Lee, Division of Infectious Diseases, Department of Internal Medicine, Mackay Memorial Hospital, 92, Sec. 2, Chung Shan North Rd., Taipei, Taiwan. Email:


Background and purpose: 

There is an increasing need for respiratory care centers (RCCs)for patients who require prolonged mechanical ventilation after intensive care unit (ICU) stay. Nosocomial infections occur at a high rate in ICUs, but there have been few studies of nosocomial infections in RCCs in Taiwan.



The infection rates, sources, and pathogens of nosocomial infections in the RCC of a tertiary hospital were retrospectively analyed from January 2001 to December 2002. Nosocomial infections were defined in accordance with the recdommendations of the Center for Disease Control in the United States.



There were 398nosocomial infections in 265 patients (1.5episodes for each patient). The incidence density of nosocomial infection was 27.3%. The mean age +- stardard deviation of patients were 74.5+- 12.8 years. The mean duration of infection from the day of patient trasfer to the RCC was 13 days (range, 2-78 days). Urinary ract infection was most common (53.8%), followed by bloodstream infection (31.2%), skin and soft tissue infection (6.0%, and lower respiratory tract infection (5.5%). 481 strains of microorganisms were isolated, 12.8% of which were Staphylococcus aureus (all methicillin-resistant), 11.1% WERE kLEBSIELLA PNEUMONIAE (69.1% of which were the extended spectrum B-lactamase (ESBL) phenotype), and 10.6% were Escherichai coli(31.4% of which were the ESBL phenotype).



The infection incidence density in the RCC was smiliar to previous findingsfor ICUs during the same period. However, there were differences in the distribution of sites and pathogens. Multiple drug resistance rates were high


Key words:

Cross infection; Drug resistance, microbial; Respiratory care unit.