Abstract
Objectives. Classification on multiple criteria of Gram-negative bacilli (GNBs) according to antibiotic resistance. Material and method. Retrospective study (January 2017-December 2018) carried out in the Infectious Diseases Clinic from Craiova; GNBs were identified using the Vitek 2 automated system, which subsequently established their sensitivity to antimicrobials; GNBs were classified based on an arbitrary score from 1 (minimum) to 5 (maximum) based on the multiple antibiotic resistance index (MAR), the percentage of multidrug resistant strains (MDR) and the percentage of extended resistance strains (XDR). The final classification represents the sum of the points awarded for each category considered. Results. The following GNBs were considered: Escherichia coli (n = 720), Klebsiella pneumoniae (n = 335), Pseudomonas aeruginosa (n = 139), Proteus mirabilis (n = 60) and Acinetobacter baumannii (n = 29). MAR values are: Acinetobacter baumannii (Ab) – 0.6, Proteus mirabilis (Pm) – 0.52, Pseudomonas aeruginosa (Pa) – 0.51, Klebsiella pneumoniae (Kp) - 0.37 and Escherichia coli (Ec) – 0.23. The percentage of MDR strains is: Pm – 76.67%, Kp – 68.86%, Pa - 58.71%, Ec – 51.94% and Ab – 51.72%; XDR strains were identified for Ab - 17.24% and Pa – 6.47%. The final classification of GNBs is as follows: Pa – 12p, Ab - 11 p, Pm – 7p, Kp – 6p, Ec – 3p. Conclusions. Depending on the resistance profile on multiple criteria, the classification of the studied Gram-negative bacteria is as follows: Pa, Ab, Pm, Kp, Ec.
Highlights
Gram-negative bacilli are an important category of microorganisms, responsible for human infections located in various sites such as the meningeal space, lungs, urinary tract, intra-abdominal space, bones, joints or wounds
GNBs were classified based on an arbitrary score from 1 to 5, depending on the multiple index of antibiotic resistance (MAR), the percentage of multidrug resistant strains (MDR) and extended drug resistant stains (XDR)
The calculation of the multiple antibiotic resistance index (MAR) and the interpretation of results are based on the work of Krumpelman PH [7], while the criteria for defining MDR and, respectively, XDR for the GNBs are those proposed by Magiorakos et al [8]
Summary
Gram-negative bacilli are an important category of microorganisms, responsible for human infections located in various sites such as the meningeal space, lungs, urinary tract, intra-abdominal space, bones, joints or wounds. Antimicrobial resistance is considered one of the greatest threats to humanity (alongside the climate changes), it is worldwide spreaded (with varying degrees) and it was recognozed as a major health problem by the United Nations in a special meeting (September 2016) [4]. In 2017 the World Health Organisation (WHO) has published a list of pathogens for which new antibiotics are urgently needed due to their resistance to antibiotics [5]. On that list 5 out of 12 pathogens are Gram-negative bacilli and, more important, the first category (Critical) contains only this kind of germs (carbapenems resistant Acinetobacter baumannii, carbapenems resistant Pseudomonas aeruginosa, Enterobacteriaceae resistant to carbapenems or producing extensive spectrum betalactamases). In 2015 plasmidmediated polymyxin-resistance gene were discovered in China
Sign-in/Register to view highlights & summary 
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call