Prevalence and Antibiotic Resistance of ESKAPE Pathogens Isolated in the Emergency Department of a Tertiary Care Teaching Hospital in Hungary: A 5-Year Retrospective Survey

Abstract

Antibiotic treatments initiated on Emergency Departments (ED) are empirical. Therefore, knowledge of local susceptibility patterns is important. Despite this, data on expected pathogens and their resistance profile are scarce from EDs internationally. The study aim was to assess the epidemiology and resistance patterns of bacterial isolates from a tertiary-care ED over 5 years, focusing on ESKAPE bacteria (including the Enterobacterales group). After removal of duplicates, n = 6887 individual bacterial isolates were recovered, out of which n = 4974 (72.22%) were ESKAPE isolates. E. coli was the most frequent isolate (2193, 44.1%), followed by the Klebsiella genus (664; 13.4%). The third most frequent isolate was S. aureus (561, 11.3%). In total, multi-drug resistance (MDR) was present in 23.8% and was most prevalent in A. baumanii (65.5%), P. mirabilis (42.7%), and K. pneumoniae (32.6%). MRSA was isolated in 19.6%, while ESBL-producing Enterobacterales in 17.7%, and these were associated with remarkably higher resistance to other antibacterials as well. Difficult-to-treat resistance (DTR) was detected in 0.5%. The frequent isolation of some ESKAPE bacteria and the detected considerable acquired resistance among ED patients raise concern. The revealed data identified problematic pathogens and will guide us to set up the optimal empiric antibiotic protocol for clinicians.

Multidrug-Resistant and Extensively Drug-Resistant Enterobacteriaceae: Prevalence, Treatments, and Outcomes – A Retrospective Cohort Study

“… 22 A large study on the resistance patterns of the bacterial isolates obtained from an emergency department in Hungary revealed 23.8% of the bacterial isolates to be MDR. 20 Only one local study on the E. coli isolates reported 67% prevalence rate of MDR infections. 23 The factor that attributed to the high prevalence rate of MDR infections observed in this study was the critically ill health of the patients, compared to the previous report on patients that involved both ICU and non-ICU patients.…”

“… 2 Extended-spectrum beta-lactamase (ESBL)-producing organisms are defined as the ones that confer resistance to most beta-lactam antibiotics, including penicillin, cephalosporins, and aztreonam. 20 They generally remain susceptible to carbapenems and may be inhibited in vitro by beta-lactam/beta-lactamase inhibitor combinations. Although CTX-M-type ESBLs belonging to the ambler class A are the most common ESBLs, TEM- and SHV-ESBLs are also detected.…”

“…Carbapenemase-producing Enterobacteriaceae (CPE) are defined as organisms resistant to imipenem, meropenem, doripenem, or ertapenem, or documented to possess a carbapenemase. 20 A molecular platform can be further used to detect carbapenemases of ambler class A, B, and D, including Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-beta-lactamase (NDM), and oxacillinase-48 (OXA-48).…”

<p>Effect of the Short-Term Use of Fluoroquinolone and β-Lactam Antibiotics on Mouse Gut Microbiota</p>

“…The use of broad-spectrum antibiotics to cure infectious diseases has improved human health. 25 , 26 However, the widespread use of these medications can lead to significant spatiotemporal changes in the gut microbiota. 7 , 27 Here we assessed the impact of four commonly used antibiotics on gut microbiota and immunity in mice.…”

Composite P(3HB-3HV)-CS Spheres for Enhanced Antibiotic Efficiency

“…aeruginosa ) and two Gram-positive strains ( S. aureus , E. faecalis ). All considered bacterial species have a great biomedical impact, being involved in community and nosocomial infections [ 78 , 79 ] while developing increased antibiotic resistance rates in the last decades [ 80 , 81 ].…”