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We performed a 6-year retrospective study to provide valuable insight into appropriate antibiotic use in HAI cases. We also aimed to understand how hospitals could reduce pathogen drug resistance in a population that overuses antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All data (2012\u20132017) were obtained from the hospital information warehouse and clinical microbiology laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We isolated 1392 pathogen strains from patients admitted to the orthopedics department during 2012\u20132017.\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      (14.7%, 204\/1392),\n                      <jats:italic>Enterobacter cloacae<\/jats:italic>\n                      (13.9%, 193\/1392), and\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (11.3%, 157\/1392) were the most common pathogens causing nosocomial infections. The dominant Gram-negative bacterium was\n                      <jats:italic>E. coli<\/jats:italic>\n                      , with high resistance to ampicillin, levofloxacin, cotrimoxazole, gentamicin, and ciprofloxacin, in that order.\n                      <jats:italic>E. coli<\/jats:italic>\n                      was least resistant to amikacin, cefoperazone-sulbactam. The most dominant Gram-positive bacterium was\n                      <jats:italic>S. aureus<\/jats:italic>\n                      , highly resistant to penicillin and ampicillin, but not resistant to fluoroquinolones and cotrimoxazole. Analysis of risk factors related to multidrug-resistant bacteria showed that patients with open fractures (Gustillo III B and IIIC) were significantly more susceptible to methicillin-resistant\n                      <jats:italic>S. aureus<\/jats:italic>\n                      infections (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;\u20090.05). Additionally, extended-spectrum \u03b2-lactamase-producing\n                      <jats:italic>E. coli<\/jats:italic>\n                      infections occurred significantly more often in patients with degenerative diseases (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;\u20090.05). Elderly patients tended to be more susceptible to multidrug-resistant bacterial infections, but this outcome was not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Antimicrobial resistance is a serious problem in orthopedics. To effectively control antimicrobial resistance among pathogens, we advocate extensive and dynamic monitoring of MDR bacteria, coupled with careful use of antibiotics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-021-02234-7","type":"journal-article","created":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T05:03:16Z","timestamp":1612155796000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Drug resistance of pathogens causing nosocomial infection in orthopedics from 2012 to 2017: a 6-year retrospective study"],"prefix":"10.1186","volume":"16","author":[{"given":"Xiaowei","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runsheng","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banglin","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxiang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niya","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"issue":"2","key":"2234_CR1","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.ajic.2009.06.010","volume":"38","author":"JA Weigelt","year":"2010","unstructured":"Weigelt JA, Lipsky BA, Tabak YP, Derby KG, Kim M, Gupta V. 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