Eight-year trends in the relative isolation frequency and antimicrobial susceptibility among bloodstream isolates from Greek hospitals: data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance – WHONET-Greece, 2010 to 2017

Abstract

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.

Correlation between Acinetobacter baumannii Resistance and Hospital Use of Meropenem, Cefepime, and Ciprofloxacin: Time Series Analysis and Dynamic Regression Models

“…Consequently, only 5.5% of the strains were sensitive to all the aforementioned antimicrobial classes. These findings are in accordance with previously reported data concerning the alarming resistance rates and resistance trends over time (1996–2017) of A. baumannii in Greek hospitals [ 27 , 28 ]. The distribution of isolates in terms of the biological sample and the hospital department is presented in Table 2 .…”

Distribution and Antimicrobial Susceptibility of Gram-Positive and Gram-Negative Pathogens Isolated from Patients Hospitalized in a Tertiary Teaching Hospital in Southwestern China

“…Our results showed that the species of the five domi-nant bacteria were consistent with those reported in studies in other regions, including the CHINET for China (5), Zhengzhou (China) (6), Nanjing (China) (26), Seoul (Korea) (27), Somalia (28), and Greece (21), but the proportions of the five dominant bacteria were different. Therefore, it was necessary to analyze the proportions of bacteria in different areas.…”

“…In the whole hospital and ICUs, the resistance rates of A. baumannii to ceftazidime, cefepime, imipenem, and meropenem were higher than those reported by CHINET surveillance (5) and those in Zhengzhou (6) and Kazakhstan (32) but lower than those reported in Nanjing and Lebanon. However, in the whole hospital and ICUs, the resistance rates of P. aeruginosa to all the antimicrobial agents were lower than those reported by CHINET surveillance (5) and those in Zhengzhou (6), Nanjing (26), and Greece (21). We also found that P. aeruginosa was more sensitive to ceftazidime and cefepime than to imipenem and meropenem in our study.…”

<p>Optimal Empiric Treatment for <em>Klebsiella pneumoniae</em> Infections in Short-Stay ICU Patients During Continuous Renal Replacement Therapy: Results from a Population Pharmacokinetic/Pharmacodynamic Analysis</p>

“…From several previous surveillance studies, K. pneumoniae is one of the most prevalent bloodstream isolates in ICUs. 27,28 Thus, it is critical to know local trends in resistance and population-MIC distributions as well as the best regimens to maximise the efficacy and minimise the probability of toxic effects. In our study, the resistance of K. pneumoniae to IMP was 41.9%, which was lower than that of previous studies reported.…”

“…In our study, the resistance of K. pneumoniae to IMP was 41.9%, which was lower than that of previous studies reported. 27,28 This may be that severe infections have been occurred in some patients before they were admitted to ICU. As excepted, IMP and PT failed to achieve promising CFRs against all the tested K. pneumoniae because of highly resistant pathogens.…”