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

Andreea-Loredana Golli; Oana Mariana Cristea; Ovidiu Zlatian; Adina-Dorina Glodeanu; Andrei Theodor Balasoiu; Mihaela Ionescu; Simona Popa

doi:10.2147/IDR.S383285

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

Infect Drug Resist. 2022 Oct 17:15:5981-5992. doi: 10.2147/IDR.S383285. eCollection 2022.

Authors

Andreea-Loredana Golli^#¹, Oana Mariana Cristea^#², Ovidiu Zlatian², Adina-Dorina Glodeanu^#³, Andrei Theodor Balasoiu⁴, Mihaela Ionescu⁵, Simona Popa⁶

Affiliations

¹ Department of Public Health and Management, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
² Department of Microbiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
³ Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
⁴ Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
⁵ Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
⁶ Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of Craiova, Craiova, Romania.

^# Contributed equally.

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.

Keywords: antimicrobial resistance; bacterial strains; blood cultures; retrospective study.