Bacterial Isolates from Endotracheal Aspirates and their Antimicrobial Resistance Pattern in Patients from Intensive Care Unit

Andreea Loredana Golli,Mihai Olteanu,Maria Balasoiu,Roxana Maria Nemes,Beatrice Mahler Boca,Sorin Ioan Tudorache,Floarea Mimi Nitu

doi:10.37358/rc.19.9.7538

Abstract

The emergence of multidrug-resistant (MDR) pathogens, especially for intensive care unit (ICU) patients is a serious threat to public health. To determine the frequency and antibiotic resistance pattern of bacterial pathogens isolated from tracheal aspirates of the patients admitted in ICU. The retrospective study included endotracheal aspirates from 734 patients admitted to the ICU, from January to December 2017. The analysis of the resistance patterns for the action of the appropriate antibiotics was performed using Vitek 2 Compact system and diffusion method. A total of 985 bacterial isolates were obtained, of which 227 strains of Klebsiella spp. (23.04%), followed by Nonfermenting Gram negative bacilli, other than Pseudomonas and Acinetobacter (NFB) (170- 17.25%), MRSA (134- 13.60%). Isolation rates indicates a higher value for male patients and elderly patients (over 65 years), statistically significant. High rates of MDR were found for Klebsiella spp. (70.04%) and Pseudomonas aeruginosa (66.25%) while almost all of the isolated NFB strains were MDR (98.82%). The study revealed high rates of MDR pathogens in the majority of ICU isolates which may be due to unnecessary use of higher generations of antibiotics, use of mechanical devices, age, comorbidities, and can determine a higher rate of morbidity and mortality among these patients.

Highlights

The emergence of multidrug-resistant (MDR) pathogens, especially for intensive care unit (ICU) patients is a serious threat to public health
According to the European Antimicrobial Resistance Surveillance Network (EARS- Net), Improving Patient Safety in Europe (IPSE) and European Centre for Disease Prevention and control (ECDC) data, Romania is one of the South-Eastern European countries with one of the highest prevalence rates of MDR pathogens. [4, 5] A worrying phenomenon in Romania is the existence of the MDR-TB and XDR-TB cases in socio-economic conditions, with the doubling of number of cases of XDR-TB in the last years [6,7,8], including the cases of extrapulmonary tuberculosis which originates from the hematogenous metastatic affects developed during the prime TB infection period [9]
In our study we have analysed the percentage of multidrug-resistant (MDR) strains among the endotracheal aspirates from ICU patients, by taking into consideration resistance to at least three different antibiotic groups: aminoglycosides, cephalosporins, carbapenems, tetracyclines and fluoroquinolones. 85.88% from the Acinetobacter spp. strains were MDR

Summary

Introduction

The emergence of multidrug-resistant (MDR) pathogens, especially for intensive care unit (ICU) patients is a serious threat to public health. The most common isolate of the Gram negative pathogens was Klebsiella spp. Referring to the total number of samples collected by gender, isolation rates indicates a higher value for male patients, especially for NFB, E.coli, Klebsiella, Acinetobacter spp.

Results

Conclusion