Prevalence survey on antimicrobial use & multidrug resistance in tertiary level university hospital

Abstract

Introduction Excessive and inappropriate use of antibiotics is highly associated with the emergence of antibiotic resistance. Antibiotic resistance reduces the effectiveness and number of options for antibiotic treatment, leading to increased morbidity, mortality, and health care expenditures. This study aimed to characterize antimicrobial prescriptions and to determine multidrug resistance (MDR prevalence in tertiary-level university hospitals (TLUH). Methods It was a point-prevalence survey of antimicrobial use in the two TLUH of Southern Tunisia, in 2019. For inpatients receiving antimicrobials, detailed information was collected. Results Totally, 1047 inpatients were included in our study. The sex ratio (male/female) was 1.1. The mean age was 50 ± 12 years. Overall, 410 cases (39.2%) were on antimicrobials. A significant association was noted between receiving antimicrobial drugs and admission in intensive care units (ICU) (65.% vs 30.2%; p < 0.001), having a surgical history, notably minimal invasive (81.9% vs 30.7%; p < 0.001)and indwelling invasive medical devices such as urinary (17.6% vs 3.9%; p < 0.001). and central vascular catheters (8.6% vs 2.2%; p < 0.001). Main antimicrobials were penicillin (26.7%), fluoroquinolones (20%) and third-generation cephalosporins (16.5%). Prophylactic indication constituted 24.9% (102 cases) of prescriptions, among which 81.3% were judged inappropriate for dose or timing while health-care associated infections accounted for 46.4% of all prescriptions. Parenteral route was prescribed in 302 cases (73%). Antibiotic indications were documented 221 cases (53.9%). Of 78 isolates, 50% were multidrug resistant strains, among which the commonest pathogen was extending-spectrum-beta lactamase producing Escherichia Coli (10 cases,25.6%). Conclusions This study demonstrated a high prevalence of antimicrobial use and MDR which needs addressing especially for surgical prophylaxis and empirical broad-spectrum antimicrobial prescriptions. Key messages High prevalence of multidrug resistance. The needs to addressing especially for surgical prophylaxis and empirical broad-spectrum antimicrobial prescriptions.

Analyses of the Antibiofilm Activity of o-Phenanthroline Monohydrate against Enterococcus faecalis and Staphylococcus aureus and the Mechanisms Underlying These Effects

“…5 Both bacteria have a strong ability to produce biofilms, 6 which can cause skin and soft tissue infections, septicemia, infective endocarditis, osteomyelitis, and other diseases. 7 Numerous studies have substantiated the occurrence of plasmid-mediated conjugation transfer within species such as Enterococcus, Staphylococcus, Streptococcus and Listeria, indicating an escalating risk of interbacterial multidrug resistance. 8 Analysis of the global burden of antimicrobial resistance revealed that drug-resistant bacteria caused 4.95 million fatalities in 2019, surpassing those attributed to human immunodeficiency virus/acquired immunodeficiency syndrome or malaria.…”

“…Enterococcus faecalis and Staphylococcus aureus are the main causes of clinical infection . Both bacteria have a strong ability to produce biofilms, which can cause skin and soft tissue infections, septicemia, infective endocarditis, osteomyelitis, and other diseases . Numerous studies have substantiated the occurrence of plasmid-mediated conjugation transfer within species such as Enterococcus, Staphylococcus, Streptococcus and Listeria , indicating an escalating risk of interbacterial multidrug resistance .…”