| Autor: |
Ghenea AE; Department of Bacteriology-Virology-Parasitology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Cioboată R; Department of Pneumology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Drocaş AI; Department of Urology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Țieranu EN; Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Vasile CM; Department of Pediatric Cardiology, County Clinical Emergency Hospital of Craiova, 200349 Craiova, Romania., Moroşanu A; Department of Paediatrics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Țieranu CG; Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania., Salan AI; Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania., Popescu M; Department of Endocrinology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Turculeanu A; Department of Bacteriology-Virology-Parasitology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Padureanu V; Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Udriștoiu AL; Faculty of Automation, Computers and Electronics, University of Craiova, 200776 Craiova, Romania., Calina D; Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Cȃrţu D; 1st Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Zlatian OM; Department of Bacteriology-Virology-Parasitology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania. |
| Abstrakt: |
The study evaluated the evolution of the incidence of infections with Klebsiella in the County Clinical Emergency Hospital of Craiova (SCJUC), Romania. Also, we monitored antibiotic resistance over more than two years and detected changes in resistance to various antimicrobial agents. Our study included 2062 patients (823 women and 1239 men) hospitalised in SCJUC during the period 1st of September 2017 to 30 June 2019. In 458 patients (22.21%) from the 2062 total patients, the collected samples (1116) were positive and from those, we isolated 251 strains of Klebsiella spp. We conducted a longitudinal analysis of the prevalence of Klebsiella spp. over calendar months, which showed a prevalence in surgical wards that ranged between 5.25% and 19.49% in June 2018, while in medical wards the variation was much wider, between 5.15% and 17.36% in April 2018. Klebsiella spp. strains showed significant resistance to Amoxicillin/Clavulanate, Aztreonam and Cephalosporins such as Ceftriaxone, Ceftazidime and Cefepime. We examined the possible link with the consumption of antibiotics in the same month by performing a multiple linear regression analysis. The evolution of antibiotic resistance in Klebsiella was correlated with the variation of resistance in other bacteria, which suggests common resistance mechanisms in the hospital environment. By performing the regression for dependency between antibiotic resistance and antibiotic consumption, we observed some correlations between antibiotic consumption and the development of antibiotic resistance after 1, 2 and even 3 months (e.g., resistance to meropenem was influenced by the consumption in the hospital ward of imipenem 1 month and two months before, but only 1 month before by the consumption of meropenem). The clustering of strains showed filiation between multiresistant Klebsiella spp. strains isolated from specific patients from the ICU. The evolution of prevalence and antibiotic resistance in Klebsiella correlated with the resistance in other bacteria, which suggest common resistance mechanisms in the hospital environment, and also with the consumption of antibiotics. |
