Antimicrobial resistance and beta-lactamase gene distribution among clinical isolates: a two-year cohort study

A cohort investigation evaluated patient demographic information together with microbial detection patterns and antimicrobial drug resistance in a total group of 2,098 patients. Results showed an equally distributed sample consisting of 51.8% inpatients matched with 47.2% outpatients. In comparison, females comprised 51.8% of the total participants, and most patients fell within middle age categories and the elderly (58.5% aged 41-80 years). The patient demographic data showed that among 2,098 cases (14.7% were between 81 and 100 years old, and 1.2% reached the centenarian category thus demonstrating an increasing demand for geriatric healthcare services. Urine samples produced (72.9%) bacterial isolates above the combination of blood cultures and wound specimens (each with 9.7%). The comparison between 2022 and 2023 proved noteworthy, with healthcare facility admission rates escalating from 316 to 771 patient cases while outpatient walk-in numbers decreased from 587 to 403, along with a substantial rise in urinary tract infection isolates from 648 to 883 cases. The tests on antimicrobial resistance demonstrated that Imipenem (95%), along with Tigecycline (97%), were effective, but Norfloxacin (97.1%) and Cotrimoxazole (46%) had notable resistance patterns. The results showed an ESBL detection rate of 312 among Escherichia coli isolates, but MBL counts reached 83, and AmpC beta-lactamase production amounted to 142. blaCTX-M emerged as the leading ESBL gene type (38.1%) among a total of 142 collected E. coli strains, which also demonstrated blaOXA-48 (25.3%) and blaNDM (22.7%) as their prevalent MBL genes. Multiple resistance genes have become more prevalent in MBL isolates, as demonstrated by the simultaneous presence of blaVIM and blaNDM genes in (5.3%) of MBL isolates. The research results demonstrate the immediate requirement for better-controlling mechanisms in antimicrobial use and improved infection surveillance and control procedures following the detection of emerging resistance pathogens.