Antimicrobial resistance of selected invasive bacteria in a tertiary care center: results of a prospective surveillance study

Abstract

Introduction: We aimed to report the distribution and resistance patterns of eight invasive clinically relevant bacteria surveyed in the Clinical Center of Serbia (CCS) in Belgrade. Methodology: A total of 477 clinical blood stream isolates of Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecium, Enterococcus faecalis, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter spp. were collected in the period from January to December 2013. Antimicrobial susceptibility testing was performed using standard methods and interpreted using the Clinical and Laboratory Standards Institute (CLSI) breakpoint criteria. Results: Acinetobacter spp. was the most prevalent bacteria encountered (37%), followed by K. pneumoniae (25.7%). Multidrug resistance was observed in 92.5% of all isolates. Out of 177 strains of Acinetobacter spp., 97.7% were resistant to fluoroquinolones and carbapenems. Resistance to aminoglycosides, fluoroquinolones, and third-generation cephalosporins was 97.1%, 95.4%, and 95.8% among K. pneumoniae and 21.4%, 21.7%, and 31% among E. coli isolates, respectively. In total, 65.1% of K. pneumoniae and 12.1% of E. coli isolates were determined to be extended-spectrum beta-lactamase (ESBL) positive. High-level aminoglycoside resistance of E. faecalis was 71.4%, and glycopeptide resistance of E. faecium was 95%. Out of 66 strains of S. aureus, 63.4% were methicillin resistant. Conclusions: The majority of bloodstream isolates of clinically relevant bacteria in CCS were multidrug resistant. The biggest concerns are carbapenem-resistant Acinetobacter spp., K. pneumoniae, and P. aeruginosa; third-generation cephalosporin-resistant E. coli; vancomycinresistant E. faecium; and methicillin-resistant S. aureus. Stricter measures of infection control and antibiotic use are needed.

Antimicrobial Susceptibility Trends among Pathogens Isolated from Blood: A 6-Year Retrospective Study from a Tertiary Care Hospital in East Sikkim, India

“…9,14 On the contrary, few gram-positive cocci in our study were vancomycinresistant, which is similarly reported by Zhu et al 9 Similar to the findings by Djuric et al, the overall resistance among gram-negative isolates was observed highest to β-lactams, trimethoprim-sulfamethoxazole, and aminoglycosides. 13 The MDRI of commonly isolated gram-negative bacilli was alarmingly high and remained consistently high throughout our study period. The resistance pattern is comparable to reports indicating a predictable rise of MDR organisms in the future.…”

“…Similar to several studies, gram-negative bacilli were the common isolates (60.2%) in our study. 8,[13][14][15] Gram-positive cocci were the commonly isolated organisms at the beginning of our study in 2013, with CoNS as the frequently isolated group. 16 However, by 2014 onward, upward trend of gram-negative bacilli isolation increased when compared with a decline in the frequency of CoNS isolation.…”

“…Overall, a gradual decrease in isolation of both types of organisms, with gram-positive cocci more so, could perhaps be attributed to a better understanding of sample collection, infection control, and prevention. 9,13 In our study, the rise in total antibiotic resistance of S. aureus is of concern. Till 2017, S. aureus had the lowest MDR index values, but by 2018, it had abruptly risen to become the organism with the third-highest values.…”

Bacterial bloodstream infections in level-I trauma intensive care unit in Serbia: incidence, causative agents and outcomes

“…and Acinetobacter spp. strains to carbapenems has been previously reported in Serbia in prospective surveillance study within Clinical Centre of Serbia [35] and from CEASAR in 2016 [34]. In contrary, surveillance networks in USA, National Healthcare Safety Network (NHSN) and International Nosocomial Infection Control Consortiu (INNIC) [36,37] and highincome countries of European Antimicrobial Resistance Surveillance Network (EARS-Net) [38] reported considerably lower rates of isolates resistant to common AMR markers, reflecting the differences in measures of primary BSI prevention and control.…”

Research Article Characterization and molecular epidemiology of extensively prevalent nosocomial isolates of drug-resistant <i>Klebsiella pneumoniae</i>

“…A high prevalence of drug resistance microorganisms has been reported. In a study by Djuric et al (2016), more than 95% of the analyzed strains were multidrug resistant, and 65% had an extended spectrum beta-lactamase. All K. pneumonie nosocomial isolates in our study were drug resistant ( Table 1).…”