Antibacterial Resistance in Lower Respiratory Tract Bacterial Pathogens: A Multicenter Analysis from Turkey

Abstract

Introduction: This study aimed to evaluate the etiology of lower respiratory tract infections (LRTIs) and their antibiotic resistance.
 Methodology: Bacterial culture results of LRT samples from 17 hospitals between 2016-2019 were included in the study. All isolates were identified and AST were performed by automated microbiology systems. AST was performed according to EUCAST.
 Results: Non-duplicate 30,051 (26,890 HA and 3156 CA) isolates detected as causative pathogen. LRTIs are caused by 85.1% Gram-negative bacterial pathogens and 14.9% Gram-positive. The most common isolates among HA pathogens were Acinetobacter spp. (27.4%), P.aeruginosa (22.2%), K.pneumoniae (17.9%); among CA pathogen S.pneumoniae (19.9%), P. aeruginosa (18.9%), H.influenzae (14.6%). ESBL rate was 62.5% in K.penumoniae; 53.1% in E.coli; 19.1% in Klebsiella spp; 13.9% in Enterobacter spp.; 8.6% in Proteus spp.; 6.3% in Citrobacter spp.; and 4.3% in Serratia spp. Resistance rates to carbapenems and colistin were 92.8% and 12.8% in A baumannii, 39.8% and 7.5% in P.aeruginosa, 47.3% and 18.5% in K.penumoniae. Among staphylococci, 27.3% of S. aureus and 82.4% of CoNS were methicillin resistant. 7.6% of E.faecium and 0.9% of E.faecalis were vancomycin resistant. Linezolid resistant S. aureus, CoNS, E.faecalis and E.faecium rates were 0.3%, 2.9%, 0.0% and 4.6%. Inducible clindamycin resistant rate was 17.2% in S. aureus 38.2% in CoNS. Non-susceptible S.pneumoniae isolate rate to penicillin was 37.0%. 6.5% of S.maltophilia and 4.4% of B.cepacia isolates were resistant to trimethoprim/sulfamethoxazole.
 Conclusions: Antibiotic resistance was mainly observed among A.baumannii and K.pneumoniae and continuous surveillance of antimicrobial resistance patterns in the management of LRTIs is important.

Prevalence and risk factors for Lower Respiratory Tract Infection: a Multicenter study, at Kebbi State, Nigeria

“…The distribution of bacteria isolated from patients with lower respiratory tract infection where Staphylococcus aureus (31.1%) was the most predominant bacteria isolated in this location followed by Klebsieella pneumoniae (22.2%), Klebsiella oxytoca (13.9%), Escherichia coli (11.1%), Pseudomanas aeruginosa (5.6%), Aeromonas hydrophila (5.6%), Acinetobacter baumannii (4.6%), B. pseudomallei (2.8%) and Proteus spp (2.8%) in order of ranking (TABLE 2). The distribution of aetiology of lower respiratory tract as recorded in this study is similar to the previous study at National Hospital Abuja [28], study in Shanghai, China from 2013 to 2015 [29], a multicenter Analysis from Turkey [30] and Ethiopia [31] except that, in addition, the current study isolated Aeromonas hydrophila and B. pseudomallei. Some studies from neighbouring countries such as Yaoundé, Cameroon [32] and other studies in some part of Europe [33] documented S. pneumoniae as the leading pathogen of LRTIs followed by H. influenzae which contradict the current findings where Staphylococcus aureus were the most prevalence bacteria isolated followed by Klebsiella spp, this is similar to the findings in Bangladesh as reported by Borkot et al, [27] and some studies from southern Ethiopia [34] (TABLE 3).…”

Antimicrobial Resistance Trends in Community Acquired Pneumonia at Secondary care Centres in Central India: Time to Develop Community Antimicrobial Stewardship Program

“…Most of these studies focus mainly in intensive care units of tertiary care centres. A comparative analysis of observed global AMR patterns in non-tertiary care centres is presented below in Table -2 Rajasthan, India [16] Turkey [22] North America [23,24] Europe [23,24] Asia pacific region [23,24] Latin America [23,24] Escherichia coli A similar extensive study has been reported in SENTRY trial from Latin America analysing patterns of AMR in different infections highlighting the need for community level anti microbial stewardship practices [24,25]. [15,16,26,27].…”

Antimicrobial Susceptibility Pattern of Bacterial Pathogens Isolated from Patients with Lower Respiratory Tract Infection in Kebbi State, Nigeria

“…The rise in multidrug resistance is a growing public health concern among agents of respiratory tract which is responsible for morbidity, mortality and costs (Uskudar et al, 2021), this make management of respiratory tract infections a great challenge in Africa due to the socioeconomic burden and limited access to 2010), in which in a similar study, out of 232 total isolates, 114 (49.1%) were from males while 118 (50.9%) from females. This also contradicts previous ndings in 11 European countries (Belgium, Spain, Poland, Slovakia, UK, Slovenia, Sweden, Italy, France, Germany, and Netherland) where 60% of the female were reported with LRTIs (Ieven et al, 2018).…”