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Prevalence of Multidrug-Resistant Pathogens Causing Bloodstream Infections in an Intensive Care Unit
Andreea-Loredana Golli1, Oana Mariana Cristea2, Ovidiu Zlatian2
1Department of Public Health and Management, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
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.
Insights
Bloodstream infections in the ICU show a high prevalence of multidrug-resistant (MDR) pathogens. Urgent control measures are needed to combat the alarming rates of resistant bacteria, particularly Gram-negative strains.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Intensive Care Medicine
Background:
- Bloodstream infections (BSIs) are critical complications in intensive care units (ICUs), associated with high mortality rates.
- The emergence and spread of multidrug-resistant (MDR) pathogens pose a significant threat to patient outcomes in critical care settings.
Purpose of the Study:
- To analyze the distribution, resistance patterns, and prevalence of MDR pathogens in blood samples from ICU patients with severe invasive infections.
- To identify key bacterial species contributing to BSIs and their antimicrobial susceptibility profiles.
Main Methods:
- A retrospective study was conducted on 490 ICU patients between 2017 and 2020.
- Bacterial isolates from blood samples were identified, and antimicrobial resistance patterns were analyzed using the Vitek 2 Compact system.
Main Results:
- 617 bacterial isolates were recovered, with Gram-positive bacteria (69.21%) being more prevalent than Gram-negative bacteria (30.79%).
- Key pathogens included Coagulase-negative staphylococci (CoNS), Klebsiella pneumoniae, Methicillin-Resistant Staphylococcus aureus (MRSA), Acinetobacter baumannii, and Enterococcus faecalis.
- High MDR rates were observed for Acinetobacter baumannii (97.77%), Klebsiella pneumoniae (50%), and MRSA (46.55%), with over 60% of K. pneumoniae strains resistant to carbapenems.
Conclusions:
- The study highlights an alarming prevalence of MDR pathogens in ICU bloodstream infections.
- Consistent implementation of infection control measures is crucial to mitigate the impact of these resistant organisms.
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