Evolution in Epidemiology and Antimicrobial Resistance Patterns of Bacteria Among Dermatology Patients: A Retrospective Study in a Tertiary Dermatology Hospital in China (2018–2023)

Shi Chen,1 Xinzheng Li,2 Jiyun Tian1 1Department of Microbiology Laboratory, Hangzhou Third People’s Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China; 2Department of Clinical Laboratory, Hangzhou Third People’s Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaCorrespondence: Xinzheng Li, Department of Clinical Laboratory, Hangzhou Third People’s Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, No. 38 Xihu Avenue, Hangzhou, 310009, People’s Republic of China, Email [email protected]: This study analyzed the epidemiology and antimicrobial resistance of dermatology patients to supplement general surveillance with dermatology-related data, guide the prudent use of antimicrobials, provide a template for antimicrobial stewardship programme and interrupt the spread of drug-resistant bacteria.Methods: A retrospective study analyzed bacterial isolates from dermatology patients between 2018 and 2023. Statistical analysis was carried out using WHONET 2023, IBM SPSS 26, Excel 2021, and R 4.3.3, using chi-square and Cochran-Armitage tests to identify differences and trends.Results: The study found the bacterial isolation rate of 32.88% in dermatology patients. Positive cultures were more common in males, aged 60 or older, outpatients, and dermatologic surgery patients. Gram-positive bacteria (GPB) isolation rates increased from 2018 to 2020 and decreased thereafter. Secretion was most common in positive specimen types. Primary infections had higher isolation rates than secondary infections. Eczema, dermatitis, and herpes zoster were the most diagnosed skin conditions. Staphylococcus aureus was the most common pathogen, while coagulase-negative Staphylococcus (CoNS) exhibited higher antimicrobial resistance. Clindamycin resistance in β-hemolytic Streptococcus (BHS) and tetracycline resistance in Enterococcus spp. were the highest among GPB. Except for ampicillin, the resistance rates of Enterobacterales to common antimicrobials were below 30%. Acinetobacter baumannii and Pseudomonas aeruginosa exhibited low antimicrobial resistance to most common antimicrobials. Rates of methicillin-resistant S. aureus and CoNS (MRSA and MRCoNS), and carbapenem-resistant A. baumannii (CRAB) decreased while erythromycin-resistant BHS (ERBHS), linezolid-resistant Enterococcus (LRE), extended-spectrum β-lactamases-producing Enterobacterales (ESBL-E), and carbapenem-resistant P. aeruginosa (CRPA) rates increased, and carbapenem-resistant Enterobacterales (CRE) rates remained stably low.Conclusion: The findings revealed that the bacterial distribution and antimicrobial resistance patterns among dermatology patients exhibit distinct characteristics. Ongoing surveillance is crucial for tracking these patterns and supporting informed decisions on anti-infective therapies.Keywords: dermatology, skin and soft tissue infections, bacteria, antimicrobial resistance, multidrug resistant