Multi-Drug Resistant Bacteria as Aetiological Factors of Infections in a Tertiary Multidisciplinary Hospital in Poland

Abstract

Global and local initiatives were recently undertaken to reduce the burden of antibiotic resistance. The aim of the study was to describe the incidence and the aetiology of bacterial infections among hospitalized patients with special attention paid to the multidrug resistant (MDR) bacteria. This retrospective study was based on prospectively collected data from 150,529 consecutive patients hospitalized in a tertiary multidisciplinary hospital in the years 2017–2019. All consecutive microbiological tests from any biological material performed in the analyzed period were included. Microbiological screening tests (n = 10,677) were excluded. The analysis was focused on aetiological factors of bacterial infections, especially the incidence of MDR bacteria and mechanisms of antibiotic resistance. There were 58,789 microbiological tests performed in the analyzed period. The highest testing rate was noticed for intensive care unit (mean of 3.1 tests per one patient), followed by neonatal intensive care unit (2.7), internal medicine (1.9), pediatrics (1.8), and urology (1.2). Among 58,789 tests, 7690 (13.1%) were positive. MDR bacteria were responsible for 1783 infections (23.2%). The most common antibiotic resistance mechanism reported was ESBL production by Klebsiella spp. or Escherichia coli or Enterobacter spp. isolates (47.3% of all MDR cases). ESBL cases were followed by MRSA (14.7%), VRE (14.2%) and MBL producing Klebsiella spp. (5.6%). Among all infections caused by MDR bacteria, 1175 (65.9%) were diagnosed after 72 h of hospitalization (hospital-acquired infections). Apart from AmpC and ESBL producing Escherichia coli, all MDR bacteria were significantly more common in hospital-acquired infection. MDR bacteria are aetiological factors of a significant portion of infections in hospitalized patients with no remarkable change in the incidence in recent years. Production of ESBL is the most common mechanism of antibiotic resistance and should be regarded as one of the most urgent problems in clinical microbiology.

Great Plasticity in a Great Pathogen: Capsular Types, Virulence Factors and Biofilm Formation in ESBL-Producing Klebsiella pneumoniae from Pediatric Infections in Uruguay

“…According to antibiotype, MDR phenotype was found in 62% of the isolates studied regardless of the guideline used. This percentage aligns with the range reported in other studies involving clinical isolates of Enterobacterales [28,29]. The presence of the MDR phenotype was associated with the main ESBL gene characterized, bla CTX-M-15 .…”

Epidemiological Study of Pathogens in Spontaneous Bacterial Peritonitis in 2017–2024—A Preliminary Report of the University Hospital in South-Eastern Poland

“…Bacterial isolation was similar in in-hospital and non-hospital infections (53% versus 49%). In total, 28.1% of the organisms detected in the study showed multi-drug resistance, the most common being E. coli ESBL, followed by S. aureus MRSA [38][39][40].…”

Bacterial Resistance in Hospital-Acquired Infections Acquired in the Intensive Care Unit: A Systematic Review

“…There are a large number of studies reporting MDR pathogens in different parts of the world, which would explain the factors that trigger the increase in epidemic outbreaks, morbidity and mortality, with significant direct and indirect costs (8,10,11,12,15,17,29,34,37,50,62,65,68,87,91). The most frequently reported MDR microorganisms in this last decade were found among isolates of K. pneuomaniae, E. coli, P. aeruginosa, A. baumannii, SARM and VRE.…”

“…In the last decade, the increase in antimicrobial resistance in ICUs has been reported, mainly due to the spread of these multidrug-resistant (MDR) bacteria (8)(9)(10)(11)(12). MDR is defined as resistance to more than one agent in three or more antimicrobial categories, extensively-drug resistant bacteria (XDR), is defined as non-susceptibility to at least one agent in all but two or fewer antimicrobial categories (i.e., bacterial isolates remain susceptible to only one or two categories), and pan-drug resistant bacteria (PDR) is defined as non-susceptibility to all agents in all antimicrobial categories (9).…”