Background
Antimicrobial resistance (AMR) changes over time and continuous monitoring provides insight on trends to inform both empirical treatment and public health action.
Aims
To survey trends in relative isolation frequency (RIF) and AMR among key bloodstream pathogens using data from the Greek Electronic System for the Surveillance of AMR (WHONET-Greece).
Methods
This observational study looked into routine susceptibility data of 50,488 blood culture isolates from hospitalised patients in 25 tertiary hospitals, participating in the WHONET-Greece for trends over time between January 2010 and December 2017. Only the first isolate per species from each patient was included. Hospital wards and intensive care units (ICUs) were analysed separately.
Results
During the study, the RIF of
Acinetobacter baumannii
increased in wards, as did the proportion of
A. baumannii
isolates, which were non-susceptible
to most antibiotics in both wards and ICUs. Coincidently,
Klebsiella pneumoniae
RIF declined while the respective rates of non-susceptible isolates to carbapenems and gentamicin increased.
Pseudomonas aeruginosa
RIF remained stable but decreasing proportions of non-susceptible isolates to all studied antibiotics, except imipenem were observed.
Escherichia coli
RIF increased as did the proportion of isolates non-susceptible to third-generation cephalosporins, carbapenems and fluoroquinolones. Concerning
Staphylococcus aureus
, a decline in the percentage of meticillin resistant isolates in ICUs was found, while the percentages of
Enterococcus faecium isolates with
non-susceptibility to vancomycin stayed stable.
Conclusions
Recognising these trends over time is important, since the epidemiology of AMR is complex, involving different ‘bug and drug’ combinations. This should be taken into consideration to control AMR.