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

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.

Prevalence of Multidrug-Resistant Pathogens Causing Bloodstream Infections in an Intensive Care Unit

“…In other studies conducted with the aim of highlighting the MDR strains which caused other types of infections besides BSI, Klebsiella ranks first among isolated microorganisms, 12 , 14 , 15 with the same findings in other researchers’ studies. 16 …”

“…In our research, both Coagulase-negative Staphylococci (CoNS) and MRSA showed high resistance to penicillin and fluoroquinolones, which is similar to other studies. 12 , 14 , 15 , 34 …”

Pre- and Post-COVID-19 Antimicrobial Resistance Pattern of Pathogens in an Intensive Care Unit

“…isolates revealed a very high level of resistance against third-generation cephalosporins (over 95%), carbapenems (around 90%), piperacillin-tazobactam (around 90%), fluoroquinolones (around 90%), and aminoglycosides (around 85%). These findings are consistent with those from other studies [28][29][30][31] and with data on antibiotic consumption and antibiotic resistance in Romania, showing an increasing extended resistance (for A. baumannii, carbapenem resistance was 93.6% and multi-resistance was 89.4%, occupying third place for both indicators among EARS Net states) [15]. A significantly increasing trend was also observed in the antimicrobial resistance rate against colistin (p < 0.001), which is an issue of great concern because colistin remains one of the very few antibiotics which are consistently active against these bacterial species.…”

Updates on Staphylococcal Vaccines

“…S. aureus colonizes a wide variety of tissues, which can either result in less-severe manifestations such as folliculitis, or in potentially fatal infections like pneumonia, endocarditis, osteomyelitis, and sepsis [6,7]. The pathogen is known to cause recurring diseases, indicating that humans do not naturally develop a strong, long-lasting immune response against it [6].…”