Abstract

Antimicrobial resistance represents one of the main threats to healthy ecosystems. In recent years, among the multidrug-resistant microorganisms responsible for nosocomial infections, the Enterococcus species have received much attention. Indeed, Enterococcus have peculiar skills in their ability to acquire resistance genes and to cause severe diseases, such as endocarditis. This study showed the prevalence and antimicrobial resistance rate of Enterococcus spp. isolated from clinical samples, from January 2015 to December 2019 at the University Hospital “San Giovanni di Dio e Ruggi d’Aragona” in Salerno, Italy. A total of 3236 isolates of Enterococcus faecalis (82.2%) and Enterococcus faecium (17.8%) were collected from urine cultures, blood cultures, catheters, respiratory tract, and other samples. Bacterial identification and antibiotic susceptibility were performed with VITEK 2. E. faecium showed a high resistance rate against ampicillin (84.5%), ampicillin/sulbactam (82.7%), and imipenem (86.7%), while E. faecalis showed the highest resistance rate against gentamicin and streptomycin high level, but both were highly sensitive to such antibiotics as tigecycline and vancomycin. Studies of surveillance are an important tool to detect changes in the resistance profiles of the main pathogens. These antimicrobial susceptibility patterns are necessary to improve the empirical treatment guideline of infections.

Highlights

  • IntroductionAntimicrobial resistance (AMR) is among the main threats to health systems globally [1]

  • The aim of this study was to evaluate the rates of antimicrobial resistance of E. faecium and E. faecalis, isolated from clinical samples from 2015 to 2019 in University Hospital, in order to identify suitable drugs for improving empirical therapy

  • A total of 3236 strains of Enterococcus spp. isolated from clinical samples were analyzed from January 2015 to December 2019 at the University Hospital “San Giovanni di Dio e

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Summary

Introduction

Antimicrobial resistance (AMR) is among the main threats to health systems globally [1]. A report from the United Nations International Committee highlights that the infections caused by multidrug-resistant microorganisms (MDRs) could cause 10 million deaths by 2050, more than today’s cancer deaths [2]. It has been estimated that MDR infections could lead to health care costs of up to $20,000 per patient, leading to a possible global health economic crisis [3]. One of the main causes of the development of AMR has been the improper and excessive use of antibiotics. It is assumed that the resistance rate to antibiotics will spread in hospital settings and in communities [6]. The use and abuse of antibiotics by factory farms is contributing to the rapid global growth and spread of AMR [7]. Among the MDR bacteria responsible for nosocomial infections, the Enterococcus spp. received particular attention due to its ability to cause urinary tract infection, bacteremia, and infective endocarditis [8,9]

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