Resistance of Gram-negative bacilli isolated from patients in ICU

Резистентность грамотрицательных бактерий в отделении реанимации
Nelya Bissenova 1, Aigerim Yergaliyeva 1, Natlya Mitus 1
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1 Department of Microbiology, JSC National Scientific Medical Research Center, Astana, Kazakhstan
J CLIN MED KAZ, Volume 4, Issue 42, pp. 46-51. https://doi.org/10.23950/1812-2892-2016-4/jcmk-00345
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ABSTRACT

Objective: to determine the spectrum of pathogens associated with nosocomial infections among ICU patients, to summarize the level of antimicrobial resistance of common pathogens and provide an overview of strategies to prevent the spread of resistance.
Methods: A prospective microbiologic study of 781 strains isolated from adult patients after cardiac surgery at ICU was conducted, during the period 2010-2014.
Results. The results of the study, 52.3% of the isolated strains (409) were Gram-negative, among which the share of non-fermenting Gram-negative bacteria accounted for 34.4% of the isolates (269), of which most frequently was Acinetobacter baumannii - 20,9% (164) and Pseudomonas aeruginosa - 13,4% (105). A. baumannii showed a high level of resistance to the III generation cephalosporins (ceftazidime - 96.9%, cefotaxime - 97.6%, ceftriaxone - 93.5%), to carbapenems at the level of 88%. Resistant strains of Pseudomonas aeruginosa to carbapenems was 63%. Among the representatives of the family Enterobacteriaceae, the highest resistance was observed in strains of Klebsiella pneumoniae, 100% resistance to cephalosporins III generation (ceftriaxone, ceftazidime), the lowest resistance to carbapenems observed (4.2% of meropenem, imipenem 11.1%).
Conclusion: In order to reduce the emergence and spread of drug-resistant strains in the ICU, it is strongly recommended to carry out microbiological monitoring and optimization of the use of antibiotics in each hospital. Therefore local resistance surveillance programs have the greatest value in the development of appropriate therapeutic recommendations for specific types of patients and infections.

CITATION

Bissenova N, Yergaliyeva A, Mitus N. Resistance of Gram-negative bacilli isolated from patients in ICU. Journal of Clinical Medicine of Kazakhstan. 2016;4(42):46-51. https://doi.org/10.23950/1812-2892-2016-4/jcmk-00345

REFERENCES

  • Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest Journal. 1999 Feb 1;115(2):462-74.
  • Standartyvzjatija, dostavki i hranenija biomateriala dlja mikrobiologicheskih issledovanij v laboratorii klinicheskoj mikrobiologii. Metodicheskieinstrukcii. Astana. 2008, Р.11-12.
  • Lu Q, Luo R, Bodin L, Yang J, Zahr N, Aubry A, Golmard JL, Rouby JJ. Efficacy of high-dose nebulized colistin in ventilatorassociated pneumonia caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2012 Dec 1;117(6):1335-47.
  • Levin PD, Golovanevski M, Moses AE, Sprung CL, Benenson S. Improved ICU design reduces acquisition of antibiotic-resistant bacteria: a quasi-experimental observational study. Critical care. 2011 Sep 14;15(5):R211.
  • Ma X, Wu Y, Li L, Xu Q, Hu B, Ni Y, Wu A, Sun S, Jarlier V, Robert J. First multicenter study on multidrug resistant bacteria carriage in Chinese ICUs. BMC infectious diseases. 2015 Aug 21;15(1):358.
  • Fluit A, Verhoef J, Schmitz F, Sentry Participants TE. Frequency of isolation and antimicrobial resistance of gram-negative and gram-positive bacteria from patients in intensive care units of 25 European university hospitals participating in the European arm of the SENTRY Antimicrobial Surveillance Program 1997–1998. European Journal of Clinical Microbiology & Infectious Diseases. 2001 Sep 25;20(9):617-25.
  • Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K. International study of the prevalence and outcomes of infection in intensive care units. Jama. 2009 Dec 2;302(21):2323-9.
  • Garcia-Rodriguez JA, Jones RN, Group AT. Antimicrobial resistance in gram-negative isolates from European intensive care units: data from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) programme. Journal of chemotherapy. 2002 Jan 1;14(1):25-32.
  • Rhomberg PR, Jones RN. Summary trends for the meropenem yearly susceptibility test information collection program: a 10- year experience in the United States (1999–2008). Diagnostic microbiology and infectious disease. 2009 Dec 31;65(4):414-26.
  • Agodi A, Barchitta M, Quattrocchi A, Maugeri A, Aldisio E, Marchese AE, Mattaliano AR, Tsakris A. Antibiotic trends of Klebsiella pneumoniae and Acinetobacter baumannii resistance indicators in an intensive care unit of Southern Italy, 2008–2013. Antimicrobial resistance and infection control. 2015 Nov 3;4(1):43.
  • Bayram A, Balci I. Patterns of antimicrobial resistance in a surgical intensive care unit of a university hospital in Turkey. BMC infectious diseases. 2006 Oct 25;6(1):155.
  • Shorr AF, Zilberberg MD, Micek ST, Kollef MH. Predictors of hospital mortality among septic ICU patients with Acinetobacter spp. bacteremia: a cohort study. BMC infectious diseases. 2014 Oct 30;14(1):572.
  • Zilberberg MD, Kollef MH, Shorr AF. Secular trends in Acinetobacter baumannii resistance in respiratory and blood stream specimens in the United States, 2003 to 2012: a survey study. Journal of hospital medicine. 2016 Jan 1;11(1):21-6.