Beta-lactam Resistance Mechanisms in Pathogens Isolated from Patients Admitted to Intensive Care Unit

Abstract

Intensive care units (ICUs) are often referred to as the epicentre of infection diseases in a hospital. Many studies highlighted the importance of using local antimicrobial resistance data, to guide empirical antibiotic therapy. As a consequence, the present study is particularly important, especially in the current context, when we are witnessing an ascending trend of antimicrobial resistance. Beta-lactams are the most frequently used class of antibiotics for treating patients infected with various germs. The aim of this study is to analyse the modalities by which microorganisms become resistant to antibiotics of this class, in an intensive care unit of a Romanian university hospital. During the period between January, the 1st 2012 and December the 31st 2013, a prospective study was conducted in the largest ICU from the Western part of Romania. Various resistance mechanisms to beta-lactam antibiotics were detected. Among these, there is great concern regarding the high number of extended-spectrum beta-lactamase producing microorganisms, as in most cases they determine the use of carbapenems, thus increasing the risk of occurrence and dissemination of carbapenemase-producing bacteria.

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

“…Our study revealed more than half of the Pseudomonas strains resistant to carbapenems and fluoroquinolones, outcomes consistent with other findings [2,24,25], and also to third and fourth-generation cephalosporins, despite the fact that there were significant decreases of the mean percentages for fluoroquinolone resistance, aminoglycoside resistance and carbapenem resistance during the period 2013 to 2016 [23],…”

The Characterization of Antibiotic Resistance of Bacterial Isolates from Intensive Care Unit Patient Samples in a University Affiliated Hospital in Romania

“…Although there were significant decreases of the mean percentages for fluoroquinolone resistance, aminoglycoside resistance and carbapenem resistance during the period 2013 to 2016 [34], our study found more than half of the Pseudomonas strains resistant to carbapenems and fluoroquinolones, outcomes consistent with other findings [3,[40][41][42][43].…”

“…Our study draws attention to the very high percentage of NFB strains resistant to cephalosporins and carbapenems, almost all strains being MDR. Axente et al [41], in a study conducted also in Romania, revealed 69.95% resistant strains to penicillins (less frequently prescribed in ICUs in present).…”

Antibiotic Resistance Pattern of Bacterial Pathogens in Elderly Patients Admitted in the Intensive Care Unit

“…The resistance to ceftazidime and cefepime observed in our study was similar to that of a previous report on multidrug-resistant Pseudomonas aeruginosa, which also revealed that 80% of P. aeruginosa were resistant to carbapenem antibiotics such as imipenem and meropenem [25,26]. 26.27% of the Pseudomonas strains have been found to be resistant to carboxypenicillins and ureidopenicillins in a study conducted by Axente et al [27].…”

“…In our study, for all the other NF-GNB strains, a high degree of resistance has been observed on cephalosporins, carbapenems and ureido-penicillins, consistent with other findings [1].Moolchandani K. et al have reported concordance resistance pattern to various classes of antimicrobials for Acinetobacter and Pseudomonas [1] Another study conducted in Romania by Axente et al evidenced an increased resistance (69.95% resistant strains) to penicillins (presently less frequently prescribed in ICUs) found in GNB [27].…”