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Abstract
Antimicrobial resistance (AMR) is one of the most serious threats in modern medicine which requires the constant monitoring of emerging trends amongst clinical isolates. However, very limited surveillance data is available in the Latvian context. In the present study, we conducted a retrospective analysis of microbiological data from one of the largest public multispecialty hospitals in Latvia from 2017 to 2020. AMR trends for 19 gram-negative bacterial (GNB) genera were investigated. During the study period, 11,437 isolates were analyzed with Escherichia spp. (34.71%), Klebsiella spp. (19.22%) and Acinetobacter spp. (10.05%) being the most isolated. Carbapenems like Meropenem and Ertapenem were the most effective against GNBs (3% and 5.4% resistance rates, respectively) while high resistance rates (>50%) were noted against both Ampicillin and Amoxicillin/Clavulanic acid. Enterobacter spp. and Klebsiella spp. showed a significant increase in resistance rate against Ertapenem (p = 0.000) and Trimethoprim-Sulfamethoxazole (p = 0.000), respectively. A decrease in the prevalence of Extended-Spectrum Beta-Lactamase positive (ESBL+) Enterobacterales was noted. Despite the lower prescription levels of the penicillin group antimicrobials than the European average (as reported in ESAC-Net Surveillance reports), GNBs showed high average resistant rates, indicating the role of ESBL+ isolates in driving the resistance rates. Constant and careful vigilance along with proper infection control measures are required to track the emerging trends in AMR in GNBs.
Highlights
Antimicrobial resistance (AMR) represents a global crisis that endangers the efficacy of the antibiotics, and the efficacy of the treatment provided
The problem gets amplified further when one considers the aging demographics in most of the developed countries and the increase in immunocompromised patients [3]. Another challenge associated with AMR is the increasing incidence of HAIs or nosocomial infections, which are defined as infections that occur more than 48 h post-admission in a hospital or medical care center and are caused by a myriad of microbes ranging from bacteria to fungi to viruses [4]
According to previously published estimates, close to 3.8 million patients contract nosocomial infections each year in the European Union (EU) [23] with close to 33,000 yearly reported deaths that can be attributed to infections that were caused by bacteria that were resistant to antimicrobials [22]
Summary
Antimicrobial resistance (AMR) represents a global crisis that endangers the efficacy of the antibiotics, and the efficacy of the treatment provided. Intrinsic factors like clustering of highly vulnerable patients, extensive use of invasive procedures, and high rates of antibiotic use are the concerning factors contributing to the development of AMR in HAIs [5]. All these factors lead to a huge financial burden on both the patients and hospitals besides the prolongation of hospitalization time
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