Antibiotic Resistance in Nosocomial Bacteria Isolated from Infected Wounds of Hospitalized Patients in Czech Republic.

Milan Kolar,Katerina Neradova,Patrik Mlynarcik,Pavel Cermak,Lenka Hobzova,Katerina Bogdanova,Pavel Bostik

doi:10.3390/antibiotics9060342

Milan Kolar, Katerina Neradova + Show 5 more

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https://doi.org/10.3390/antibiotics9060342

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Journal: Antibiotics	Publication Date: Jun 18, 2020
Citations: 6	License type: CC BY 4.0

Affiliation: Palacký University, Olomouc, Charles University

Abstract

Hospitalized patients with wounds face an increased risk of infection with multi-drug-resistant nosocomial bacteria. In this study, samples from almost 10,000 patients from big hospitals in Czech Republic with infected wounds were analyzed for the presence of bacterial pathogens. In 7693 patients (78.8%), bacterial etiological agents were identified. Members of the Enterobacterales (37.1%) and Staphyloccus aureus (21.1%) were the most prevalent pathogens. Staphyloccus aureus showed methicillin resistance in 8.6%. Almost half of the Klebsiella pneumoniae isolates were ESBL-positive and 25.6% of the Enterobacter spp. isolates were AmpC-positive. The third most prevalent Pseudomonas aeruginosa showed resistance to 19–32% of the antipseudomonal antibiotics tested. Based on the results, amoxicillin/clavulanic acid, ampicillin/sulbactam or piperacillin/tazobactam combined with gentamicin can be recommended for antibiotic treatment of infected wounds. Once the etiological agent is identified, the therapy should be adjusted according to the species and its resistance.

Highlights

Bacterial skin and soft tissues infections (SSTIs) include, in order of severity, various manifestations, such as impetigo, folliculitis, furuncle, carbuncle, erysipelas, cellulitis, fasciitis and myonecrosis.In addition, other similar infections, such as infected decubitus ulcers and leg ulcers, as well as bacterial infections of surgical wounds, which are often caused by Staphylococcus aureus, Enterococcus spp., members of the Enterobacterales order and Gram-negative non-fermenting bacteria, are usually recognized as a part of SSTIs [1]
Samples from a total of 9762 patients with diagnoses of infected decubitus ulcers, leg ulcers and bacterial infections of surgical wounds were included in this study
The results show that there were 10,977 pathogens identified in total and the most prevalent etiological agent was S. aureus (21.1%)

Summary

Introduction

Bacterial skin and soft tissues infections (SSTIs) include, in order of severity, various manifestations, such as impetigo, folliculitis, furuncle, carbuncle, erysipelas, cellulitis, fasciitis and myonecrosis.In addition, other similar infections, such as infected decubitus ulcers and leg ulcers, as well as bacterial infections of surgical wounds, which are often caused by Staphylococcus aureus, Enterococcus spp., members of the Enterobacterales order and Gram-negative non-fermenting bacteria, are usually recognized as a part of SSTIs [1]. One of the most pressing issues in medical care worldwide is the increasing resistance of various bacterial strains to the antibiotic treatment [2] This applies to the infected decubitus and leg ulcers, and bacterial infections of surgical wounds, where often the causative agents are multi-drug-resistant (MDR) bacteria. This can lead to a failure of the antibiotic therapy with all the negative effects on the overall clinical status. It means a higher mortality and shorter survival of the patients with infections caused by the MDR bacteria due to the development of complications, such as systemic infections, sepsis and septic shock [3,4]. Tumbarello et al, reported that the mortality of patients with systemic infections caused by Extended Spectrum Beta-Lactamase

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