Prevalence of Colonization with Multidrug-Resistant Bacteria: Results of a 5-Year Active Surveillance in Patients Attending a Teaching Hospital
Abstract
:1. Introduction
2. Results
3. Discussion
4. Materials and Methods
4.1. Study Design and Patient Population
4.2. Culture Conditions, Identification, and Antimicrobial Susceptibility Testing
4.3. Statistical Analysis
4.4. Ethical Considerations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Antimicrobial Category | Antimicrobial Agents | Staphylococcus aureus (Total Isolates = 493) | |
---|---|---|---|
n | % Res | ||
Penicillins | PEN | 491 | 73.9 |
OXA | 489 | 18.2 | |
Fluoroquinolones | LVX | 364 | 21.2 |
Aminoglycosides | GEN | 363 | 5.8 |
Macrolides | ERY | 363 | 32 |
Lincosamides | CLI | 361 | 29.9 |
Tetracyclines | TET | 363 | 4.4 |
Folate pathway inhibitors | SXT | 363 | 2.8 |
Glycopeptides | VAN | 364 | 0.3 |
TEC | 362 | 2.8 | |
Oxazolidinones | LZD | 364 | 0.5 |
Lipopeptides | DAP | 363 | 0.3 |
Antimicrobial Category | Antimicrobial Agent | Klebsiella pneumoniae | Escherichia coli | Acinetobacter baumannii | Enterobacter spp. | Pseudomonas aeruginosa | Other Gram-Negative Organisms 1 | Total | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(Total Isolates = 99) | (Total Isolates = 81) | (Total Isolates = 62) | (Total Isolates = 48) | (Total Isolates = 46) | (Total Isolates = 86) | (Total Isolates = 422) | |||||||||
n | % Res | n | % Res | n | % Res | n | % Res | n | % Res | n | % Res | n | % Res | ||
Penicillins | AMP | 39 | 100 | 24 | 41.7 | 15 | 100 | NT | - | 15 | 100 | 8 | 87.5 | 86 | 85.1 |
Penicillins + β-lactamase inhibitors | AMC | 99 | 38.4 | 81 | 35.8 | 9 | 100 | 48 | 100 | 9 | 100 | 63 | 66.7 | 175 | 56.6 |
TZP | 98 | 36.7 | 81 | 4.9 | NT | - | 48 | 10.4 | 45 | 15.6 | 67 | 10.4 | 59 | 17.4 | |
Second-generation cephalosporins | CXM | 11 | 9.1 | 14 | 14.3 | NT | - | 7 | 42.9 | NT | - | 18 | 22.2 | 10 | 20 |
FOX | 50 | 16 | 32 | 0 | 19 | 100 | 23 | 100 | NT | - | 34 | 41.2 | 64 | 40.5 | |
Third- or fourth-generation cephalosporins | CAZ | 99 | 36.4 | 80 | 12.5 | NT | - | 48 | 12.5 | 46 | 13 | 70 | 14.3 | 68 | 19.8 |
FEP | 99 | 35.4 | 80 | 10 | NT | - | 48 | 4.2 | 46 | 13 | 66 | 1.5 | 52 | 15.3 | |
Aminoglycosides | AMK | 97 | 16.5 | 81 | 0 | 42 | 73.8 | 48 | 0 | 46 | 6.5 | 66 | 6.1 | 54 | 14.2 |
GEN | 99 | 17.2 | 81 | 11.1 | 61 | 82 | 48 | 2.1 | 37 | 13.5 | 68 | 5.9 | 86 | 21.8 | |
Fluoroquinolones | CIP | 99 | 35.4 | 81 | 21 | 61 | 82 | 48 | 2.1 | 46 | 17.4 | 70 | 12.9 | 120 | 29.6 |
Carbapenems | IMP | 35 | 37.1 | 10 | 0 | 15 | 73.3 | 12 | 0 | 9 | 0 | 7 | 28.6 | 26 | 29.5 |
MEM | 99 | 31.3 | 81 | 0 | 61 | 82 | 48 | 0 | 46 | 10.9 | 70 | 7.1 | 91 | 22.5 | |
ETP | 89 | 25.8 | 81 | 0 | 15 | 100 | 47 | 2.1 | 15 | 100 | 65 | 6.2 | 58 | 18.6 | |
Glycylcyclines | TGC | 79 | 5.1 | 67 | 0 | NT | - | 29 | 3.4 | 13 | 100 | 43 | 11.6 | 23 | 10 |
Folate pathway inhibitors | SXT | 99 | 25.3 | 80 | 25 | 61 | 80.3 | 47 | 2.1 | 20 | 100 | 81 | 9.9 | 123 | 31.7 |
Polymyxins | CS | 87 | 10.3 | 67 | 1.5 | 59 | 0 | 40 | 0 | 38 | 0 | 44 | 47.7 | 32 | 9.6 |
AMR Pattern 1 | Klebsiella pneumoniae | Escherichia coli | Acinetobacter baumannii | Enterobacter spp. | Pseudomonas aeruginosa | Other Gram-Negative Organisms 2 | Total | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(Total Isolates = 99) | (Total Isolates = 81) | (Total Isolates = 62) | (Total Isolates = 48) | (Total Isolates = 46) | (Total Isolates = 86) | (Total Isolates = 422) | ||||||||
n | % Res | n | % Res | n | % Res | n | % Res | n | % Res | n | % Res | n | % Res | |
Carbapenems + aminoglycosides + fluoroquinolones | 99 | 21.2 | 81 | 0 | 61 | 80.3 | 61 | 0 | 46 | 8.7 | 68 | 0 | 403 | 18.4 |
Third- or fourth-generation cephalosporins + aminoglycosides + fluoroquinolones | 99 | 24.2 | 81 | 7.4 | 18 | 66.7 | 18 | 2.1 | 46 | 8.7 | 68 | 8.8 | 360 | 14.7 |
Carbapenems + aminoglycosides + fluoroquinolones + polymyxins | 87 | 5.7 | 67 | 0 | 58 | 0 | 58 | 0 | 38 | 0 | 44 | 0 | 334 | 1.5 |
Third- or fourth-generation cephalosporins + aminoglycosides + fluoroquinolones + polymyxins | 87 | 5.7 | 67 | 0 | 17 | 0 | 17 | 0 | 38 | 0 | 44 | 11.4 | 293 | 3.4 |
Antimicrobial Category | Antimicrobial Agent | Klebsiella pneumoniae | Acinetobacter baumannii | Other Gram-Negative Organisms 1 | Total | ||||
---|---|---|---|---|---|---|---|---|---|
(Total Isolates = 92) | (Total Isolates = 23) | (Total Isolates = 17) | (Total Isolates = 132) | ||||||
n | % Res | n | % Res | n | % Res | n | % Res | ||
Penicillins | AMP | 17 | 100 | 4 | 100 | 2 | 100 | 23 | 100 |
Penicillins + β-lactamase inhibitors | AMC | 92 | 87 | 3 | 100 | 14 | 92.9 | 109 | 88.1 |
TZP | 92 | 71.7 | NT | - | 15 | 53.3 | 107 | 69.2 | |
Second-generation cephalosporins | CXM | 1 | 100 | NT | - | NT | - | 1 | 100 |
FOX | 28 | 46.4 | 5 | 100 | 2 | 100 | 35 | 57.1 | |
Third- or fourth-generation cephalosporins | CAZ | 92 | 90.2 | NT | - | 16 | 87.5 | 108 | 89.8 |
FEP | 92 | 87 | NT | - | 16 | 50 | 108 | 81.5 | |
Aminoglycosides | AMK | 92 | 25 | 18 | 83.3 | 16 | 6.3 | 126 | 31 |
GEN | 92 | 51.1 | 23 | 91.3 | 15 | 33.3 | 130 | 56.2 | |
Fluoroquinolones | CIP | 92 | 84.8 | 23 | 91.3 | 17 | 52.9 | 132 | 81.8 |
Carbapenems | IMP | 29 | 65.5 | 4 | 100 | 3 | 33.3 | 36 | 66.7 |
MEM | 92 | 48.9 | 23 | 91.3 | 16 | 93.8 | 131 | 47.3 | |
ETP | 75 | 46.7 | 4 | 100 | 14 | 21.4 | 93 | 45.2 | |
Glycylcyclines | TGC | 76 | 15.8 | NT | - | 15 | 6.7 | 91 | 14.3 |
Folate pathway inhibitors | SXT | 92 | 72.8 | 23 | 91.3 | 14 | 21.4 | 129 | 70.5 |
Polymyxins | CS | 92 | 9.8 | 23 | 0 | 15 | 6.7 | 130 | 7.7 |
AMR Pattern 1 | Klebsiella pneumoniae | Acinetobacter baumannii | Other Gram-Negative Organisms 2 | Total | ||||
---|---|---|---|---|---|---|---|---|
(Total Isolates = 92) | (Total Isolates = 23) | (Total Isolates = 17) | (Total Isolates = 132) | |||||
n | % Res | n | % Res | n | % Res | n | % Res | |
Carbapenems + aminoglycosides + fluoroquinolones | 92 | 41.3 | 23 | 91.3 | 16 | 6.3 | 131 | 45.8 |
Third- or fourth-generation cephalosporins + aminoglycosides + fluoroquinolones | 92 | 62 | 5 | 100 | 16 | 25 | 113 | 58.4 |
Carbapenems + aminoglycosides + fluoroquinolones + polymyxins | 92 | 8.7 | 23 | 0 | 15 | 6.7 | 130 | 6.9 |
Third- or fourth-generation cephalosporins + aminoglycosides + fluoroquinolones + polymyxins | 92 | 8.7 | 5 | 0 | 15 | 6.7 | 112 | 8 |
Bacterial Species | AMR Pattern | 2017 | 2018 | 2019 | 2020 | 2021 | p-Values | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
n | % Res | n | % Res | n | % Res | n | % Res | n | % Res | |||
Staphylococcus aureus (493) | Penicillins | 102 | 17.5 | 94 | 20.2 | 76 | 17.9 | 94 | 18.1 | 123 | 16.9 | 0.42 |
Klebsiella. pneumoniae (191) | Carbapenems | 41 | 39 | 39 | 25.6 | 31 | 35.5 | 46 | 28.7 | 34 | 52.9 | 0.08 |
Combined resistance 1 | 41 | 31.7 | 39 | 35.9 | 31 | 54.8 | 46 | 50 | 34 | 41.2 | 0.23 | |
Escherichia coli (88) | Carbapenems | 17 | 0 | 11 | 9.1 | 19 | 0 | 20 | 0 | 21 | 0 | NA |
Combined resistance 1 | 17 | 11.8 | 11 | 9.1 | 22 | 13.6 | 20 | 10 | 21 | 4.8 | 0.9 | |
Acinetobacter baumannii (85) | Carbapenems | 17 | 88.2 | 12 | 83.3 | 11 | 81.8 | 19 | 89.5 | 25 | 96 | 0.68 |
Combined resistance 1 | 17 | 64.7 | 12 | 75 | 11 | 81.8 | 19 | 89.5 | 25 | 96 | 0.08 |
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Quirino, A.; Cicino, C.; Scarlata, G.G.M.; Marascio, N.; Di Gennaro, G.; Matera, G.; Licata, F.; Bianco, A. Prevalence of Colonization with Multidrug-Resistant Bacteria: Results of a 5-Year Active Surveillance in Patients Attending a Teaching Hospital. Antibiotics 2023, 12, 1525. https://doi.org/10.3390/antibiotics12101525
Quirino A, Cicino C, Scarlata GGM, Marascio N, Di Gennaro G, Matera G, Licata F, Bianco A. Prevalence of Colonization with Multidrug-Resistant Bacteria: Results of a 5-Year Active Surveillance in Patients Attending a Teaching Hospital. Antibiotics. 2023; 12(10):1525. https://doi.org/10.3390/antibiotics12101525
Chicago/Turabian StyleQuirino, Angela, Claudia Cicino, Giuseppe Guido Maria Scarlata, Nadia Marascio, Gianfranco Di Gennaro, Giovanni Matera, Francesca Licata, and Aida Bianco. 2023. "Prevalence of Colonization with Multidrug-Resistant Bacteria: Results of a 5-Year Active Surveillance in Patients Attending a Teaching Hospital" Antibiotics 12, no. 10: 1525. https://doi.org/10.3390/antibiotics12101525