Multidrug-Resistant Gram-Negative Bacilli: A Retrospective Study of Trends in a Tertiary Healthcare Unit

Autor: Luminița Bădițoiu, Dorina Dugaesescu, Delia Muntean, Florin-George Horhat, Iulia-Cristina Bagiu, Anca Krasta, Delia-Ioana Horhat, Victor Dumitrașcu, Dan Andrei Coșniță, Monica Licker
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Medicine (General)
medicine.medical_specialty
Gram-negative bacilli
030106 microbiology
multidrug-resistant
Bronchoalveolar Lavage
beta-Lactam Resistance
Article
law.invention
03 medical and health sciences
R5-920
Risk Factors
law
Drug Resistance
Multiple
Bacterial
Internal medicine
Gram-Negative Bacteria
Humans
Medicine
Retrospective Studies
biology
Romania
Tertiary Healthcare
business.industry
Incidence
Incidence (epidemiology)
tertiary hospital
Retrospective cohort study
General Medicine
biology.organism_classification
Proteus mirabilis
Intensive care unit
humanities
Anti-Bacterial Agents
Acinetobacter baumannii
Multiple drug resistance
Intensive Care Units
Trend analysis
Carbapenems
Observational study
Gram-Negative Bacterial Infections
business
Surgery Department
Hospital
Zdroj: Medicina; Volume 54; Issue 6; Pages: 92
Medicina
Volume 54
Issue 6
Medicina, Vol 54, Iss 6, p 92 (2018)
ISSN: 1648-9144
DOI: 10.3390/medicina54060092
Popis: Background and objective: Bacterial multidrug resistance is particularly common in Gram-negative bacilli (GNB), with important clinical consequences regarding their spread and treatment options. The aim of this study was to investigate the trend of multidrug-resistant GNB (MDR-GNB) in high-risk hospital departments, between 2000–2015, in intervals of five years, with the intention of improving antibiotic therapy policies and optimising preventive and control practices. Materials and methods: This is an observational, retrospective study performed in three departments of the most important tertiary healthcare unit in the southwestern part of Romania: the Intensive Care Unit (ICU), the General Surgery Department (GSD), and the Nutrition and Metabolic Diseases Department (NMDD). MDR was defined as acquired resistance to at least one agent in three or more antimicrobial categories. Trends over time were determined by the Cochran–Armitage trend test and linear regression. Results: During the study period, a total of 2531 strains of MDR-GNB were isolated in 1999 patients: 9.20% in 2000, 18.61% in 2005, 37.02% in 2010, and 35.17% in 2015. The most significant increasing trend was recorded in the ICU (gradient = 7.63, R² = 0.842, p <
0.001). The most common MDR-GNB in the ICU was isolated from bronchoalveolar aspiration samples. Concerning the proportion of different species, most of the changes were recorded in the ICU, where a statistically significant increasing trend was observed for Proteus mirabilis (gradient = 2.62, R2 = 0.558, p <
0.001) and Acinetobacter baumannii (gradient = 2.25, R2 = 0.491, p <
0.001). Analysis of the incidence of the main resistance phenotypes proportion identified a statistically significant increase in carbapenem resistance in the ICU (Gradient = 8.27, R² = 0.866, p <
0.001), and an increased proportion of aminoglycoside-resistant strains in all three departments, but more importantly in the ICU and GSD. Conclusion: A statistically significant increasing trend was observed in all three departments
the most significant one was recorded in the ICU, where after 2010, carbapenem-resistant strains were isolated.
Databáze: OpenAIRE
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