Bacterial Epidemiology and Antimicrobial Resistance in the Surgery Wards of a Large Teaching Hospital in Southern Italy

Esposito, Silvano; Gioia, Renato; Simone, Giuseppe De; Noviello, Silvana; Leone, Sebastiano

doi:10.4084/mjhid.2015.040

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…Gill et al showed a 41% sensitivity of Acinetobacter towards doxycycline and a 100% resistance toward meropenem and third-generation cephalosporins [9]. Esposito et al, in their study, also registered high resistance toward carbapenems [5]. Similar to our study, the most sensitivity is shown towards colistin by Qadeer and Rajan [6][7], whereas Ahmad and Esposito showed the highest sensitivity of tigecycline towards Acinetobacter.…”

Section: Discussionsupporting

confidence: 87%

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Antimicrobial Resistance Patterns: Review of the Antibiogram of a Surgical Unit in a Public Tertiary Care Hospital of Pakistan

Kathia¹,

Munir²,

Fateh³

et al. 2020

Cureus

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Introduction Antimicrobial resistance (AMR) has become a challenge in modern-day medical practice. The pace at which microbes are becoming resistant to antibiotics is greater than the discovery of novel antimicrobial agents. There is a need to study these antimicrobial patterns and, for this purpose, antibiograms should be developed at the levels of wards and hospitals and studied to guide us better on how to choose suitable empirical therapy for our patients. Methods and materials A total of 286 reports were studied, which contained the culture and sensitivity data of all the patients admitted under the care of Surgical Unit-1 in Lahore General Hospital between April 1, 2019, and October 31, 2019. All the samples for culture and sensitivity were sent to the in-house laboratory of the hospital where the reporting was done by the pathology department. They were inoculated and then intubated, and gram staining was performed. Antibiotic resistance and susceptibility were measured by the disk diffusion method according to the Clinical and Laboratory standards institute (CSLI) guidelines. Results The most common isolated organism was Escherichia coli (E. coli) in 65 (24%) patients, the next most common was Acinetobacter species in 62 (23%), followed by Pseudomonas species 52(19%), Klebsiella species 32 (13%), Staphylococcus aureus 30 (11%), Coagulase-negative Staphylococci 20 (7%), Enterobacter species (2%), and Citrobacter species (1%). The antimicrobial susceptibility of E. coli was highest for aminoglycosides and carbapenems like amikacin (78%), meropenem (71%), and imipenem (63%). Acinetobacter was most sensitive to colistin (100%), amikacin (31%), meropenem (21%), and cefoperazone + sulbactam (21%). Pseudomonas was also most sensitive to colistin (93%) and after that amikacin (52%), meropenem (52%), and imipenem (44%). Klebsiella was most sensitive to colistin (86%), imipenem (60%), and aminoglycosides (50%). Among gram-positive organisms, Staphylococcus aureus was sensitive to linezolid (100%) and vancomycin (100%). Conclusion The vast majority of isolated organisms in this study were gram-negative bacteria, and most were showing high antimicrobial resistance. The antibiograms should be developed and regularly updated at every ward and hospital. There is a need to bring more awareness about the proper use of antimicrobials among healthcare workers, and antimicrobial stewardship programs can help in this matter.

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Section: Discussionsupporting

confidence: 87%

“…The most common one was E. coli, making up almost a quarter of our total sample with a presence in 65 specimens. A study by Esposito et al also observed E. coli to be the most prevalent organism [5]. It was most commonly found in wounds.…”

Section: Discussionmentioning

confidence: 92%

Antimicrobial Resistance Patterns: Review of the Antibiogram of a Surgical Unit in a Public Tertiary Care Hospital of Pakistan

Kathia¹,

Munir²,

Fateh³

et al. 2020

Cureus

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“… 29 For these reasons, tigecycline and, in particular, colistin, were considered last resort antimicrobials for the treatment of patients infected with CR A. baumannii . 29 , 30 However, over the course of this study, colistin resistance rates were already initially high and increased from 32% in 2012–13, to 62% in 2014–15, respectively. Colistin resistance is still relatively rare in A. baumannii although this might be due to the difficulties in susceptibility testing.…”

Section: Discussionmentioning

confidence: 73%

High incidence of pandrug-resistant Acinetobacter baumannii isolates collected from patients with ventilator-associated pneumonia in Greece, Italy and Spain as part of the MagicBullet clinical trial

Nowak

Zander

Stefanik

et al. 2017

Journal of Antimicrobial Chemotherapy

177

115

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ObjectivesTo investigate the molecular epidemiology, antimicrobial susceptibility and carbapenem resistance determinants of Acinetobacter baumannii isolates from respiratory tract samples of patients diagnosed with ventilator-associated pneumonia (VAP) who were enrolled in the MagicBullet clinical trial.Methods A. baumannii isolates were prospectively cultured from respiratory tract samples from 65 patients from 15 hospitals in Greece, Italy and Spain. Susceptibility testing was performed by broth microdilution. Carbapenem resistance determinants were identified by PCR and sequencing. Molecular epidemiology was investigated using rep-PCR (DiversiLab) and international clones (IC) were identified using our in-house database.ResultsOf 65 isolates, all but two isolates (97%) were resistant to imipenem and these were always associated with an acquired carbapenemase, OXA-23 (80%), OXA-40 (4.6%), OXA-58 (1.5%) or OXA-23/58 (1.5%). Resistance to colistin was 47.7%. Twenty-two isolates were XDR, and 20 isolates were pandrug-resistant (PDR). The majority of isolates clustered with IC2 (n = 54) with one major subtype comprising isolates from 12 hospitals in the three countries, which included 19 XDR and 16 PDR isolates.ConclusionsCarbapenem resistance rates were very high in A. baumannii recovered from patients with VAP. Almost half of the isolates were colistin resistant, and 42 (64.6%) isolates were XDR or PDR. Rep-PCR confirmed IC2 is the predominant clonal lineage in Europe and suggests the presence of an epidemic XDR/PDR A. baumannii clone that has spread in Greece, Italy and Spain. These data highlight the difficulty in empirical treatment of patients with A. baumannii VAP in centres with a high prevalence of carbapenem-resistant A. baumannii.

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“…A high proportion of methicillin-resistant S. aureus and carbapenem-resistant Acinetobacter baumannii isolates were identified in a study of SSIs in large teaching hospital in Southern Italy. 38 The diversity of the study population and the different antimicrobial use could be the reason for identifying a different pattern of bacterial isolates in different study settings. The majority of GNB identified in our SSI patients were possibly due to the predominance of Gram-negative isolates from SSIs following intra-abdominal procedures.…”

Section: Discussionmentioning

confidence: 99%

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

Hamza¹,

Salama²,

Morsi³

et al. 2018

IDR

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PurposeTo measure surgical site infection (SSI) rates among gastrointestinal surgeries and to identify the associated risk factors.Patients and methodsWe conducted a multicenter, retrospective, surveillance-based study of adults undergoing gastric, colon, and small bowel (SB) procedures from January to December 2016. Univariate and multivariate analyses were conducted to determine the predictive variables in each surgery.ResultsIn total, 71 of 2,099 patients developed SSI – 0.8%, 19.8%, and 10.8% following gastric, colon, and SB surgeries, respectively. In gastric surgery, the risk factors identified by univariate analysis were age, duration, wound class, risk index, emergency, and scope use (P<0.05). Logistic regression analysis revealed that the laparoscopic approach was the only significant predictor, with an inverse relationship of SSI rate vs open gastric surgery (P<0.05). Prolonged duration was a significant risk factor for developing SSI in colon surgery, and emergency was a significant risk for development of SSI in SB surgery. Gram-negative bacilli were the main causative pathogens, with a high percentage of multidrug-resistant organisms.ConclusionVariances in SSI rates and risk factors among gastric, colon, and SB surgery were detected. The use of an endoscope in gastric surgeries exhibited a protective effect against the development of SSI. The reduction of the SSI rate can be achieved by targeted preventive interventions for the identified risk factors.

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Bacterial Epidemiology and Antimicrobial Resistance in the Surgery Wards of a Large Teaching Hospital in Southern Italy

Cited by 12 publications

References 21 publications

Antimicrobial Resistance Patterns: Review of the Antibiogram of a Surgical Unit in a Public Tertiary Care Hospital of Pakistan

Antimicrobial Resistance Patterns: Review of the Antibiogram of a Surgical Unit in a Public Tertiary Care Hospital of Pakistan

High incidence of pandrug-resistant Acinetobacter baumannii isolates collected from patients with ventilator-associated pneumonia in Greece, Italy and Spain as part of the MagicBullet clinical trial

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

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