Cargando…
A 2-Year Single-Centre Audit on Antibiotic Resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae Strains from an Intensive Care Unit and Other Wards in a General Public Hospital in Greece
Hospital-acquired infections, particularly in the critical care setting, are becoming increasingly common during the last decade, with Gram-negative bacterial infections presenting the highest incidence among them. Multi-drug-resistant (MDR) Gram-negative infections are associated with high morbidit...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628132/ https://www.ncbi.nlm.nih.gov/pubmed/31096587 http://dx.doi.org/10.3390/antibiotics8020062 |
_version_ | 1783434894904393728 |
---|---|
author | Feretzakis, Georgios Loupelis, Evangelos Sakagianni, Aikaterini Skarmoutsou, Nikoletta Michelidou, Sophia Velentza, Aikaterini Martsoukou, Maria Valakis, Konstantinos Petropoulou, Stavroula Koutalas, Emmanouil |
author_facet | Feretzakis, Georgios Loupelis, Evangelos Sakagianni, Aikaterini Skarmoutsou, Nikoletta Michelidou, Sophia Velentza, Aikaterini Martsoukou, Maria Valakis, Konstantinos Petropoulou, Stavroula Koutalas, Emmanouil |
author_sort | Feretzakis, Georgios |
collection | PubMed |
description | Hospital-acquired infections, particularly in the critical care setting, are becoming increasingly common during the last decade, with Gram-negative bacterial infections presenting the highest incidence among them. Multi-drug-resistant (MDR) Gram-negative infections are associated with high morbidity and mortality, with significant direct and indirect costs resulting from long hospitalization due to antibiotic failure. As treatment options become limited, antimicrobial stewardship programs aim to optimize the appropriate use of currently available antimicrobial agents and decrease hospital costs. Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae are the most common resistant bacteria encountered in intensive care units (ICUs) and other wards. To establish preventive measures, it is important to know the prevalence of Gram-negative isolated bacteria and antibiotic resistance profiles in each ward separately, compared with ICUs. In our single centre study, we compared the resistance levels per antibiotic of P. aeruginosa, A. baumannii and K.pneumoniae clinical strains between the ICU and other facilities during a 2-year period in one of the largest public tertiary hospitals in Greece. The analysis revealed a statistically significant higher antibiotic resistance of the three bacteria in the ICU isolates compared with those from other wards. ICU strains of P. aeruginosa presented the highest resistance rates to gentamycin (57.97%) and cefepime (56.67%), followed by fluoroquinolones (55.11%) and carbapenems (55.02%), while a sensitivity rate of 97.41% was reported to colistin. A high resistance rate of over 80% of A. baumannii isolates to most classes of antibiotics was identified in both the ICU environment and regular wards, with the lowest resistance rates reported to colistin (53.37% in ICU versus an average value of 31.40% in the wards). Statistically significant higher levels of resistance to most antibiotics were noted in ICU isolates of K. pneumoniae compared with non-ICU isolates, with the highest difference—up to 48.86%—reported to carbapenems. The maximum overall antibiotic resistance in our ICU was reported for Acinetobacter spp. (93.00%), followed by Klebsiella spp. (72.30%) and Pseudomonas spp. (49.03%). |
format | Online Article Text |
id | pubmed-6628132 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-66281322019-07-23 A 2-Year Single-Centre Audit on Antibiotic Resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae Strains from an Intensive Care Unit and Other Wards in a General Public Hospital in Greece Feretzakis, Georgios Loupelis, Evangelos Sakagianni, Aikaterini Skarmoutsou, Nikoletta Michelidou, Sophia Velentza, Aikaterini Martsoukou, Maria Valakis, Konstantinos Petropoulou, Stavroula Koutalas, Emmanouil Antibiotics (Basel) Article Hospital-acquired infections, particularly in the critical care setting, are becoming increasingly common during the last decade, with Gram-negative bacterial infections presenting the highest incidence among them. Multi-drug-resistant (MDR) Gram-negative infections are associated with high morbidity and mortality, with significant direct and indirect costs resulting from long hospitalization due to antibiotic failure. As treatment options become limited, antimicrobial stewardship programs aim to optimize the appropriate use of currently available antimicrobial agents and decrease hospital costs. Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae are the most common resistant bacteria encountered in intensive care units (ICUs) and other wards. To establish preventive measures, it is important to know the prevalence of Gram-negative isolated bacteria and antibiotic resistance profiles in each ward separately, compared with ICUs. In our single centre study, we compared the resistance levels per antibiotic of P. aeruginosa, A. baumannii and K.pneumoniae clinical strains between the ICU and other facilities during a 2-year period in one of the largest public tertiary hospitals in Greece. The analysis revealed a statistically significant higher antibiotic resistance of the three bacteria in the ICU isolates compared with those from other wards. ICU strains of P. aeruginosa presented the highest resistance rates to gentamycin (57.97%) and cefepime (56.67%), followed by fluoroquinolones (55.11%) and carbapenems (55.02%), while a sensitivity rate of 97.41% was reported to colistin. A high resistance rate of over 80% of A. baumannii isolates to most classes of antibiotics was identified in both the ICU environment and regular wards, with the lowest resistance rates reported to colistin (53.37% in ICU versus an average value of 31.40% in the wards). Statistically significant higher levels of resistance to most antibiotics were noted in ICU isolates of K. pneumoniae compared with non-ICU isolates, with the highest difference—up to 48.86%—reported to carbapenems. The maximum overall antibiotic resistance in our ICU was reported for Acinetobacter spp. (93.00%), followed by Klebsiella spp. (72.30%) and Pseudomonas spp. (49.03%). MDPI 2019-05-15 /pmc/articles/PMC6628132/ /pubmed/31096587 http://dx.doi.org/10.3390/antibiotics8020062 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Feretzakis, Georgios Loupelis, Evangelos Sakagianni, Aikaterini Skarmoutsou, Nikoletta Michelidou, Sophia Velentza, Aikaterini Martsoukou, Maria Valakis, Konstantinos Petropoulou, Stavroula Koutalas, Emmanouil A 2-Year Single-Centre Audit on Antibiotic Resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae Strains from an Intensive Care Unit and Other Wards in a General Public Hospital in Greece |
title | A 2-Year Single-Centre Audit on Antibiotic Resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae Strains from an Intensive Care Unit and Other Wards in a General Public Hospital in Greece |
title_full | A 2-Year Single-Centre Audit on Antibiotic Resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae Strains from an Intensive Care Unit and Other Wards in a General Public Hospital in Greece |
title_fullStr | A 2-Year Single-Centre Audit on Antibiotic Resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae Strains from an Intensive Care Unit and Other Wards in a General Public Hospital in Greece |
title_full_unstemmed | A 2-Year Single-Centre Audit on Antibiotic Resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae Strains from an Intensive Care Unit and Other Wards in a General Public Hospital in Greece |
title_short | A 2-Year Single-Centre Audit on Antibiotic Resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae Strains from an Intensive Care Unit and Other Wards in a General Public Hospital in Greece |
title_sort | 2-year single-centre audit on antibiotic resistance of pseudomonas aeruginosa, acinetobacter baumannii and klebsiella pneumoniae strains from an intensive care unit and other wards in a general public hospital in greece |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628132/ https://www.ncbi.nlm.nih.gov/pubmed/31096587 http://dx.doi.org/10.3390/antibiotics8020062 |
work_keys_str_mv | AT feretzakisgeorgios a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT loupelisevangelos a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT sakagianniaikaterini a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT skarmoutsounikoletta a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT michelidousophia a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT velentzaaikaterini a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT martsoukoumaria a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT valakiskonstantinos a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT petropouloustavroula a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT koutalasemmanouil a2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT feretzakisgeorgios 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT loupelisevangelos 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT sakagianniaikaterini 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT skarmoutsounikoletta 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT michelidousophia 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT velentzaaikaterini 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT martsoukoumaria 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT valakiskonstantinos 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT petropouloustavroula 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece AT koutalasemmanouil 2yearsinglecentreauditonantibioticresistanceofpseudomonasaeruginosaacinetobacterbaumanniiandklebsiellapneumoniaestrainsfromanintensivecareunitandotherwardsinageneralpublichospitalingreece |