Prevalence of Multidrug-Resistant Pathogens Causing Bloodstream Infections in an Intensive Care Unit

Abstract

Introduction Bloodstream infections are the most severe infections that cause the highest mortality rate, especially in patients admitted to the intensive care unit (ICU). In this study, we aimed to analyze the distribution, resistance patterns and prevalence of MDR (multidrug-resistant) pathogens isolated in blood samples collected from patients with severe invasive infections hospitalized in the ICU. Methods A retrospective study of bacterial pathogens was performed on 490 patients admitted to the ICU between 2017 and 2020. The resistance patterns were analyzed using Vitek 2 Compact system. Results In total, 617 bacterial isolates were obtained. Four hundred and twenty-seven isolates (69.21%) were Gram positive and 190 isolates (30.79%) were Gram negative bacteria. The most frequently isolated micro-organisms identified in the blood samples for the entire period (2017–2020) were Coagulase-negative staphylococci (CoNS) (318–51.54%), followed by Klebsiella pneumoniae (70–11.34%), Methicillin-Resistant Staphylococcus aureus (MRSA) (58–9.40%), Acinetobacter baumannii (45–7.29%) and Enterococcus faecalis (42–6.80%). The number of Klebsiella pneumoniae strains significantly increased in 2020, compared to the previous year (p < 0.05). The Acinetobacter baumannii prevalence was significantly higher in the age group of 20–64 years (10.89%) and over 65 years (3.53%) (p < 0.001). The difference between the prevalence of CoNS in the elderly (67.84%) and in adults (20–64 years) (52.47%) was also statistically significant (p < 0.001). High rates of MDR were found for Acinetobacter baumannii (97.77%), Pseudomonas aeruginosa (65%), Klebsiella pneumoniae (50%), Enterococcus faecalis (47.61%) and MRSA (46.55%). More than 60% of the Klebsiella pneumoniae strains were found to be resistant to carbapenems. Conclusion The study revealed an alarming prevalence of MDR strains isolated in blood samples of the patients admitted to the ICU, indicating the necessity of consistent application of the measures to control.

Prevalence of Multidrug-Resistant Pathogens Causing Neonatal Early and Late Onset Sepsis, a Retrospective Study from the Tertiary Referral Children’s Hospital

“…Our research revealed that 7.91% of the tested Klebsiella pneumoniae strains were resistant to colistin, which is lower than a study conducted in Romania (21%), 12 but slightly higher than a study in Iran (6.9%). 40 This poses a significant public health risk, considering the rapid emergence of MDR Gram-negative bacteria and the limited development of new anti-infective agents.…”

“…Nearly 90% of the isolated CoNS strains were resistant to penicillin, over 80% to erythromycin, 65.73% to clindamycin, and 50.81% to trimethoprim/sulfamethoxazole, which was much higher than a study conducted in Romania (78.93% resistant to penicillin, 72.96% to erythromycin, and 59.12% to clindamycin). 12 Notably, we detected 2 (0.81%) linezolid-resistant CoNS strains, while a study from China reported a linezolid resistance rate of 1.6%. 31 Linezolid-resistant Staphylococcus has become a new challenge for clinical anti-infective therapy.…”

“… 30 However, there were slight differences compared to a study conducted in Romania, where CoNS (51.54%), Klebsiella pneumoniae (11.34%), and Staphylococcus aureus (9.40%) were the most prevalent. 12 Another study by Robledo J reported that the leading microorganisms in neonatal sepsis were CoNS (47.1%), followed by Escherichia coli (8.9%) and Staphylococcus aureus (7.5%). 13 Similarly, a study conducted in China found that CoNS (38.0%) were the most common, followed by Escherichia coli (17.2%) and Klebsiella pneumoniae (11.4%).…”

“…The emergence of drug-resistant pathogens creates substantial challenges for the healthcare system, encompassing the diagnosis, treatment, and containment of infections caused by resistant organisms. 11 , 12 …”

Applications of tandem mass spectrometry (MS/MS) in antimicrobial peptides field: Current state and new applications

“…Antimicrobial resistance poses a substantial threat to global health and development, with the prevalence of multidrug resistance becoming increasingly common among pathogenic bacteria. Drug-resistant pathogens are a serious concern in both hospital and non-hospital settings, presenting substantial challenges to the healthcare system, encompassing issues related to the identification, management, and control of infections caused by resistant organisms [ 1 , 2 ]. Therefore, the development and application of new antimicrobial drugs are imminent.…”