scholarly journals The change of antibiotic resistance profiles over the years in Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from intensive care units

Author(s):  
M. Cem Şirin ◽  
Neval Ağuş ◽  
Nisel Yılmaz ◽  
Yeşer Karaca Derici ◽  
Sevgi Yılmaz Hancı ◽  
...  
2021 ◽  
Author(s):  
Ilknur Erdem ◽  
Ilker Yildirim ◽  
Birol Safak ◽  
Ritvan Karaali ◽  
Berna Erdal ◽  
...  

Abstract OBJECTIVE: ‘Nosocomial infections’ or ‘healthcare associated infections’ are a significant public health problem around the world. This study aimed to assess the rate of culture confirmed nosocomial infections (NIs), frequency of nosocomial pathogens and the antimicrobial resistance patterns of bacterial isolates in a University Hospital. METHODS: A retrospective evaluation of NIs in a tertiary hospital, between the years 2015 and 2019 in Tekirdag, Turkey. RESULTS : During the five years, the overall incidence rates (NI/100) and incidence densities (NI/1000 days of stay) of NIs were 2.04% (range 1.76-2.41/100) and 3.50/1000 patients-days (range 2.85-4.64/1000), respectively. 57.4 % of the infections were originated from the Intensive Care Units. The most common NIs according to the primary sites were bloodstream infections (55.3 %) and, pneumonia (20.4%). 67.5% of the isolated microorganisms as nosocomial agents were Gram negative bacteria, 24.9% of Gram positive bacteria and 7.6 % of candida. The most frequently isolated causative agents were Esherichia coli (16.7%) and Pseudomonas aeruginosa (15.7%). The rate of extended spectrum beta-lactamase production among E. coli isolates was 51.1%. Carbapenem resistance was 29.8% among isolates of Pseudomonas aeruginosa; 95.1% among isolates of Acinetobacter baumannii, 18.2% among isolates of Klebsiella pneumoniae. Colistin resistance was 2.4% among isolates of Acinetobacter baumannii. Vancomycin resistance was 5.3% among isolates of Enterococci.CONCLUSION: Our study results demonstrates the microorganisms of isolated from Intensive Care Units demonstrates high level resistance to many antimicrobial agents. The rising in incidence of multidrug-resistant microorganisms indicate that more interventions are urgently needed to reduce NIs in our ICUs.


2016 ◽  
Vol 22 (1) ◽  
pp. 17 ◽  
Author(s):  
Ishrat Irfan Ali ◽  
Irfan Ali Khan ◽  
Muhammad Kashif Munir ◽  
Sheikh Ajaz Rasool

<p><strong>Abstract</strong></p><p><strong>Purpose:  </strong>To determine the pattern of antibiotic resistance in clinical isolates of Acinetobacter baumannii from ICU’s of tertiary care hospital in Karachi.</p><p><strong>Study Design:  </strong>A case control study.</p><p><strong>Methods:  </strong>Three hundred and fifteen clinical isolates of Acinetobacter baumannii collected from different ICUs were evaluated during 1 year period. The isolates were identified by morphology, growth and biochemical characteristics, susceptibility to a panel of anti-microbial agents in disc diffusion assay and molecular characterization by PCR using glt A and gyr B genes.</p><p><strong>Results:  </strong>94% of Acinetobacter spp were detected as multi drug resistant (MDR) and sensitive to Polymixin B only. About 6% Acinetobacter spp were also MDR but sensitive to Polymixin B, Meropenem and Salbactum + Cefoperazone. All tested isolates exhibited differing resistance representation, as establish by medium incorporation – replica method, against different tested antibiotics, as follows: Amoxicillin – Cal-vulanic acid, Tazobactam, Ceftriaxone, Ceftazidime, Meropenem, Imipenem, Gentamicin, Amikacin, Chlo-ramphenicol, Cotrimoxazole, Tobramycin, Salbactam, Cefoperazone, Gentamicin and Amikacin. All the isolates of Acinetobacter baumannii were PCR positive for glt A and gyr B.</p><p><strong>Conclusions:  </strong>Acinetobacter baumannii is the most frequently isolated and alarming pathogen in the health care system specifically for the patients in intensive care units (ICUs). Its survival in hospital environment is because of tolerance the antibiotics and antiseptic pressures. Multi drug resistance made this pathogen the lethal pathogen of this century to infect debilitated patients. There is a strict need to monitor the surveillance of global clones at institutional and or intra-institutional level for accurate treatment, precise prevention and batter control.</p>


Author(s):  
Tram Anh Que

TÓM TẮT Đặt vấn đề: Viêm phổi liên quan thở máy là bệnh lý nhiễm khuẩn bệnh viện rất thường gặp trong đơn vị hồi sức tích cực. Có nhiều vi khuẩn gây viêm phổi liên quan thở máy, trong đó các vi khuẩn Gram âm không lên men như Acinetobacterbaumannii, Pseudomonasaeruginosa,.. là những vi khuẩn gây bệnh hàng đầu và có mức độ kháng kháng sinh cao. Phương pháp: Một nghiên cứu mô tả cắt ngang được thực hiện ở các chủng vi khuẩn Gram âm không lên men phân lập được từ các mẫu đờm của bệnh nhân thở máy trên 48 giờ điều trị tại các khoa Hồi sức tích cực - Ngoại khoa Bệnh viện Hữu nghị Đa khoa Nghệ An năm từ 1/2020 đến 6/2021. Kết quả: Phân lập được 120 chủng Vi khuẩn Gram âm không lên men, trong đó, Acinetobacter baumannii 85 chủng, Pseudomonas aeruginosa 31 chủng. Acinetobacter baumannii có mức độ đề kháng trên 70% với tất cả các kháng sinh thử nghiệm, trong đó kháng cao nhất với Ceftriaxone 96,9%. Pseudomonas aeriginosa kháng với tất cả các kháng sinh thử nghiệm, kháng cao nhất với Gentamycin 80,0%, kháng thấp nhất với Piperacillin/Tazobactam 32,3%. Kết luận: Vi khuẩn không lên men là những tác nhân chính gây viêm phổi liên quan thở máy, phổ biến nhất là Acinetobacter baumannii và Pseudomonas aeruginosa. Những vi khuẩn này kháng cao với các kháng sinh thử nghiệm, trong đó, A. baumannii kháng trên 70% các kháng sinh thử nghiệm, P. aeruginosa kháng tất cả kháng sinh thử nghiệm với mức độ khác nhau tử 32,3 - 80,0%. ABSTRACT ANTIBIOTIC RESISTANCE OF NON - FERMENTABLE GRAM - NEGATIVE BACTERIA CAUSING PNEUMONIA IN PATIENTS WITH MECHANICALLY VENTILATION Background: Ventilator - associated pneumonia is a very common nosocomial infection in the intensive care unit. Many bacteria cause ventilator - associated pneumonia, in which non - fermentative Gram - negative bacteria such as Acinetobacter baumannii, Pseudomonas aeruginosa, etc., are the leading pathogens and have high antibiotic resistance. Methods: A cross sectional descriptive study was conducted on non - fermentative bacteria strains causing ventilator - associated pneumonia which were isolated at the Surgical Intensive Care Unit Department of Nghe An General Friendship Hospital from January 2020 to June 2021. Results: A total of 120 strains of non - fermenting Gram - negative bacteria were isolated. Of these, 85 strains were Acinetobacter baumannii, 31 strains was Pseudomonas aeruginosa. Acinetobacter baumannii has a resistance rate of more than 70% with all tested antibiotics, of which the highest resistance is to Ceftriaxone 96.9%. Pseudomonas aeriginosa was resistant to all tested antibiotics, with the highest resistance to Gentamycin80.0%, the lowest resistance to Piperacillin/Tazobactam 32.3%. Conclusion: Non - fermentative bacteria are the main pathogens of ventilator - associated pneumonia. The most common pathogens were Acinetobacter baumannii and Pseudomonas aeruginosa. These bacteria were highly resistant to the tested antibiotics. In which, A. baumannii resisted over 70% of the tested antibiotics, and P. aeruginosa resisted all tested antibiotics with varying degrees from 32.3 to 80.0%. Keywords: Ventilation associated pneumonia, VAP, P. aeruginosa, A. baumannii.


Author(s):  
Fabrício Rota FRANÇA ◽  
Thaíse Lucimara HAUCH ◽  
Carmem Costa MARTINS ◽  
Elena Carla Batista MENDES ◽  
Dora Inés KOZUSNY-ANDREANI

As Infecções Relacionadas à Assistência à Saúde (IRAS) em Unidade de Terapia Intensiva estão relacionadas ao estado clínico dos pacientes, procedimentos invasivos, tempo de internação prolongado e colonização por microrganismos resistentes. O estudo objetiva identificar a incidência de infecção relacionada à assistência à saúde em uma Unidade de Terapia Intensiva, distribuição por microrganismo e respectivas sensibilidades antimicrobianas. Trata-se de um estudo retrospectivo, documental de abordagem quantitativa. Foi realizado levantamento dos índices de infecção hospitalar em pacientes da Unidade de Terapia Intensiva de um hospital de médio porte, registrados em fichas de notificação do Serviço de Controle de Infecção Hospitalar (SCIH), no período de abril a dezembro de 2016. Foram analisadas 120 culturas de pacientes internados no período de março a dezembro de 2016, sendo 61 (50,83%) do sexo masculino e 59 (49,17%) do sexo feminino. Foram identificados vários microrganismos em diferentes culturas, a serem: E.coli, Klebsiella pneumoniae, Staphylococcus coag Neg, Acinetobacter baumannii e Pseudomonas aeruginosa. A maioria dos microrganismos é sensível a amicacina, ampicillin/sulba, ceftazidima, ceftriaxona, imipenem, piperacillin e sulfazotrim. A incidência de pneumonia associada à ventilação mecânica foi de 22,11% e de infecção urinária associada a cateter vesical de demora correspondeu a 6,34%. Os microrganismos identificados são comuns na maioria das Unidades de Terapia Intensiva e a incidência de infecção mostrou-se baixa em relação aos índices estipulados pelo Ministério da Saúde. Os resultados podem contribuir com a instituição hospitalar pesquisada para intensificar a educação continuada sobre higienização das mãos e a prevenção de infecção relacionada à assistência à saúde.   INFECTION INCIDENCE RELATED TO HEALTH ASSISTANCE AT AN INTENSIVE CARE UNIT IN A MEDIUM-SIZE HOSPITAL ABSTRACT Infections Related to Health Assistance (IRHA) at Intensive Care Units are related to the clinical status of the patients, invasive procedures, long period of hospitalization and resistant microorganism colonization. This study aims to identify the incidence of infections related to health assistance at an Intensive Care Unit, distribution by microorganism and respective antimicrobial sensitiveness.  It is a retrospective document of quantitative approach. It was conducted a survey of hospital infection rates from patients at Intensive Care Unit in a medium-size hospital, they were recorded in notification forms of Hospital Infection Control Service (HICS), from April to December 2016. From March to December 2016, 120 cultures of hospitalized patients were analyzed, they were 61 (50,83%) male gender and 59 (49,17%) female gender. Several microorganisms were identified in different cultures, being them: E.coli, Klebsiella pneumoniae, Staphylococcus coag Neg, Acinetobacter baumannii and Pseudomonas aeruginosa. Most of the microorganisms is amikacin sensitive, ampicillin/sulba, ceftazidime, ceftriaxone, imipenem, piperacillin and sulfazotrim. The pneumonia incidence associated to mechanical ventilation was 22,11% and urinary infection associated to permanent vesical catheter was 6,34%. The microorganisms identified are common in most of Intensive Care Units and the incidence of infections was low regarding to the rates specified by Health Ministry. The results may contribute with the present hospital institution in order to intensify continuing education about hands sanitizing and infection prevention related to health assistance.  keywords: Hospital infection. Intensive Care Unit. Microorganisms.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xiao Meng ◽  
Jintao Fu ◽  
Yue Zheng ◽  
Weidong Qin ◽  
Hongna Yang ◽  
...  

Background: There is little evidence on the changing prevalence, microbiological profile, and outcome of nosocomial Acinetobacter baumannii complex (ABC)-caused bloodstream infection (ABCBSI) specified in intensive care units (ICUs) in long-term studies, especially in China.Objective: We aimed to investigate changes in incidence, antibiotic resistance, therapy, and prognosis of ABCBSI in ICUs in eastern China during 2009–2018.Methods: A multicenter retrospective cohort study was conducted, and microbiological and clinical data for patients with ABCBSI acquired in nine adult ICUs in eastern China from 2009 to 2018.Results: A total of 202 cases were enrolled. For the years 2009–2010, 2011–2012, 2013–2014, 2015–2016, and 2017–2018, the incidence of ABCBSI increased significantly, as did the percentage of pan-drug-resistant isolates and resistant rates to most of antimicrobial agents; the percentage of drug-sensitive isolates decreased (all P &lt; 0.05). The frequency of treatment with carbapenems and tigecycline increased, and that of cephalosporins decreased. Compared with those in the first years (2009–2012), ABCBSI patients in the lattermost years (2017–2018) were less often treated with appropriate empirical therapy, more often underwent pneumonia-related ABCBSI and mechanical ventilation support, and had higher 28-day mortality rates. Multivariate Cox regression indicated that increase in the degree of ABC antibiotics resistance, pneumonia-related ABCBSI, and septic shock were risk factors of 28-day mortality and associated with significant lower survival days.Conclusions: The past decade has witnessed a marked increase in the incidence of ABCBSI and in antibiotic resistance, with increasing pneumonia-related infections and worrisome mortality in ICUs in China. Controlling increasing resistance and preventing nosocomial pneumonia may play important roles in combatting these infections.


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