Temporal trends and patterns in antimicrobial-resistant Gram-negative bacteria implicated in intensive care unit-acquired infections: A cohort-based surveillance study in Istanbul, Turkey

被引：22

作者：

Durdu, Bulent ^{[1
]}

Kritsotakis, Evangelos, I ^{[2
]}

Lee, Andrew C. K. ^{[2
]}

Torun, Perihan ^{[3
]}

Hakyemez, Ismail N. ^{[1
]}

Gultepe, Bilge ^{[4
]}

Aslan, Turan ^{[1
]}

机构：

[1] Bezmialem Vakif Univ, Fac Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[2] Univ Sheffield, Fac Med Dent & Hlth, Sch Hlth & Related Res, 30 Regent St, Sheffield S1 4DA, S Yorkshire, England

[3] Bezmialem Vakif Univ, Fac Med, Dept Publ Hlth, Istanbul, Turkey

[4] Bezmialem Vakif Univ, Fac Med, Dept Microbiol, Istanbul, Turkey

来源：

JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE | 2018年 / 14卷

关键词：

Gram-negative bacteria; Antimicrobial resistance; Nosocomial infection; Intensive care unit; Surveillance; Time trends; ACINETOBACTER-BAUMANNII; PSEUDOMONAS-AERUGINOSA; COLISTIN RESISTANCE; ENTEROBACTERIACEAE; SUSCEPTIBILITY; PREVALENCE; PNEUMONIAE; HOSPITALS; BACILLI;

D O I：

10.1016/j.jgar.2018.04.015

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: This study assessed trends and patterns in antimicrobial-resistant intensive care unit (ICU)-acquired infections caused by Gram-negative bacteria (GNB) in Istanbul, Turkey. Methods: Bacterial culture and antimicrobial susceptibility data were collected for all GNB causing nosocomial infections in five adult ICUs of a large university hospital in 2012-2015. Multiresistance patterns were categorised as multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR). Temporal patterns and trends were assessed using regression analyses. Results: Of 991 pathogenic GNB recorded, the most frequent were Acinetobacter baumannii (35.3%), Klebsiella spp. (26.7%), Pseudomonas aeruginosa (18.1%) and Escherichia coli (6.7%). The overall infection rate decreased by 41% from 18.4 to 10.9 cases per 1000 patient-days in 2012 compared with 2015 (P<0.001), mostly representing decreases in bloodstream infections and pneumonias by A. baumannii and P. aeruginosa. The XDR proportion in A. baumannii increased from 52.4% in 2012 to 71.7% in 2015, but only one isolate was colistin-resistant. Multiresistance patterns remained stable in Klebsiella, with overall XDR and possible PDR proportions of 14.3% and 1.9%, respectively. A back-to-susceptibility trend was noted for P. aeruginosa in which the non-MDR proportion increased from 53.3% in 2012 to 70.6% in 2015. Moreover, 87.9% of E. coli and 39.5% of Enterobacter isolates were MDR, but none was XDR. Conclusions: Antimicrobial resistance patterns in pathogenic GNB continuously change over time and may not reflect single-agent resistance trends. The proportionate amount of antimicrobial-resistant GNB may persist despite overall decreasing infection rates. Timely regional surveillance data are thus imperative for optimal infection control. (C) 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

引用

页码：190 / 196

页数：7

共 27 条

[11]

European Centre for Disease Prevention and Control, 2017, ANT RES SURV EUR 201

[12] Deaths Attributable to Carbapenem-Resistant Enterobacteriaceae Infections [J].

Falagas, Matthew E. ;

Tensarli, Giannoula S. ;

Karageorgopoulos, Drosos E. ;

Vardakas, Konstantinos Z. .

EMERGING INFECTIOUS DISEASES, 2014, 20 (07) :1170-1175

[13]

German G. J., 2016, Canada Communicable Disease Report, V42, P91

[14] Increasing resistance of nosocomial Acinetobacter baumannii: are we going to be defeated? [J].

Guven, Tumer ;

Yilmaz, Gulruhsar ;

Guner, Hatice Rahmet ;

Kalem, Ayse Kaya ;

Eser, Fatma ;

Tasyaran, Mehmet Akin .

TURKISH JOURNAL OF MEDICAL SCIENCES, 2014, 44 (01) :73-78

[15] Impact of single room design on the spread of multi-drug resistant bacteria in an intensive care unit [J].

Halaby, Teysir ;

al Naiemi, Nashwan ;

Beishuizen, Bert ;

Verkooijen, Roel ;

Ferreira, Jose A. ;

Klont, Rob ;

Vandenbroucke-Grauls, Christina .

ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL, 2017, 6

[16] CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting [J].

Horan, Teresa C. ;

Andrus, Mary ;

Dudeck, Margaret A. .

AMERICAN JOURNAL OF INFECTION CONTROL, 2008, 36 (05) :309-332

[17] Resistance trends among clinical isolates in China reported from CHINET surveillance of bacterial resistance, 2005-2014 [J].

Hu, F-P. ;

Guo, Y. ;

Zhu, D-M. ;

Wang, F. ;

Jiang, X-F. ;

Xu, Y-C. ;

Zhang, X-J. ;

Zhang, C-X. ;

Ji, P. ;

Xie, Y. ;

Kang, M. ;

Wang, C-Q. ;

Wang, A-M. ;

Xu, Y-H. ;

Shen, J-L. ;

Sun, Z-Y. ;

Chen, Z-J. ;

Ni, Y-X. ;

Sun, J-Y. ;

Chu, Y-Z. ;

Tian, S-F. ;

Hu, Z-D. ;

Li, J. ;

Yu, Y-S. ;

Lin, J. ;

Shan, B. ;

Du, Y. ;

Han, Y. ;

Guo, S. ;

Wei, L-H. ;

Wu, L. ;

Zhang, H. ;

Kong, J. ;

Hu, Y-J. ;

Ai, X-M. ;

Zhuo, C. ;

Su, D-H. ;

Yang, Q. ;

Jia, B. ;

Huang, W. .

CLINICAL MICROBIOLOGY AND INFECTION, 2016, 22 :S9-S14

[18] Antibiotic strategies in the era of multidrug resistance [J].

Karam, George ;

Chastre, Jean ;

Wilcox, Mark H. ;

Vincent, Jean-Louis .

CRITICAL CARE, 2016, 20

[19] Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance [J].

Magiorakos, A. -P. ;

Srinivasan, A. ;

Carey, R. B. ;

Carmeli, Y. ;

Falagas, M. E. ;

Giske, C. G. ;

Harbarth, S. ;

Hindler, J. F. ;

Kahlmeter, G. ;

Olsson-Liljequist, B. ;

Paterson, D. L. ;

Rice, L. B. ;

Stelling, J. ;

Struelens, M. J. ;

Vatopoulos, A. ;

Weber, J. T. ;

Monnet, D. L. .

CLINICAL MICROBIOLOGY AND INFECTION, 2012, 18 (03) :268-281

[20] Antimicrobial Resistance in Hospital-Acquired Gram-Negative Bacterial Infections [J].

Mehrad, Borna ;

Clark, Nina M. ;

Zhanel, George G. ;

Lynch, Joseph P., III .

CHEST, 2015, 147 (05) :1413-1421

← 1 2 3 →