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Epidemiologic factors affecting antimicrobial resistance of common bacterial isolates
P D Ellner1, D J Fink, H C Neu
1Clinical Microbiology and Laboratory Information Services, The Presbyterian Hospital, New York, New York.
Insights
Antimicrobial resistance patterns differ significantly between tertiary-care and community hospitals, and even within patient groups at tertiary centers. Local data is crucial for effective treatment strategies.
Area of Science:
- Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Antimicrobial resistance (AMR) is a growing global health concern.
- Understanding resistance patterns is crucial for effective patient management.
- Variations in AMR exist between different healthcare settings and patient populations.
Purpose of the Study:
- To compare antimicrobial resistance patterns between a tertiary-care center and a primary-care community hospital.
- To identify differences in resistance among patient groups (pediatric vs. adult, inpatient vs. outpatient) within a tertiary-care setting.
Main Methods:
- Retrospective analysis of bacterial isolates and their antimicrobial susceptibility data.
- Comparison of resistance profiles between two distinct healthcare facilities.
- Stratification of data by patient demographics and healthcare setting (inpatient/outpatient).
Main Results:
- Significant differences in bacterial susceptibility were observed between pediatric and adult patient groups at the tertiary-care center.
- Inpatients at the tertiary-care center showed higher rates of resistance in staphylococcal and enterobacterial strains compared to outpatients.
- Resistance to cephalosporins, piperacillin, and aminoglycosides was significantly higher at the tertiary-care hospital than the community hospital.
- Notable differences in resistance were found for nosocomial Enterobacter and Citrobacter isolates.
Conclusions:
- Antimicrobial resistance patterns are not uniform across different healthcare settings.
- Healthcare institutions should not rely solely on generalized nationwide AMR data.
- Local surveillance and tailored strategies are essential for combating antimicrobial resistance effectively.
Abstract:
The pattern of antimicrobial resistance of common bacterial isolates obtained from various groups of patients at a large tertiary-care center was compared with the pattern of resistance seen at a primary-care community hospital. At the tertiary-care center, significant differences in susceptibility were seen between pediatric and adult groups. In the tertiary-care center, the inpatients were more likely than the outpatients to have resistant staphylococcal and enterobacterial strains. Comparison of the overall resistance at the tertiary-care center and the primary-care hospital showed that resistance to cephalosporins, piperacillin, and aminoglycosides was significantly higher at the tertiary-care hospital than at the community hospital. Striking differences were noted in the resistance of nosocomial Enterobacter and Citrobacter isolates. Hospitals should be cautious in extrapolating nationwide data to their particular institutions.