Epidemiology of Healthcare-Associated Infections Caused by Multidrug-Resistant Bacteria and Antimicrobial Resistance
Andreea Mihaela Sandu1,2, Corneliu Ovidiu Vrancianu1,3,4, Ana-Catalina Tantu5,6
1Doctoral School, Carol Davila University of Medicine and Pharmacy, Eroii Sanitari 8, District 5, 050474 Bucharest, Romania.
Abstract:
Background/Objectives: Healthcare-associated infections (HAIs), particularly those caused by multidrug-resistant (MDR) bacteria, remain a major challenge for Romanian hospitals. This study aimed to evaluate the epidemiological burden of MDR-related HAIs and to characterize the distribution of MDR bacterial isolates and their antimicrobial resistance patterns over four consecutive semesters in a Romanian tertiary care hospital. Methods: A retrospective study was conducted using data from the Electronic Registry of HAIs, clinical observation sheets, and microbiology laboratory records. An epidemiological analysis was performed on patients diagnosed with MDR-related HAIs, while a separate microbiological analysis included all MDR bacterial isolates identified during the study period. Descriptive and comparative statistical analyses were applied to assess temporal trends, pathogen distribution, and resistance profiles. Results: Of the 327 HAIs identified, 56 cases (17.13%) were caused by MDR bacteria. Most MDR-HAIs originated from the Intensive Care Unit (≈60%), with Acinetobacter baumannii and Klebsiella spp. as the predominant pathogens. Overall mortality among patients with MDR-HAIs was high (51.79%), particularly in infections caused by A. baumannii and K. pneumoniae. Microbiological analysis of MDR isolates (n = 406) revealed consistently high resistance rates to ciprofloxacin, cefepime, and ceftazidime, exceeding 95% in 2023-2024, while resistance to carbapenems surpassed 90% by the end of the study period. Temporal variability in MDR burden was observed across semesters, suggesting an influence of clinical and institutional factors. Conclusions: MDR-related HAIs represent a significant and persistent problem in Romanian acute-care hospitals, particularly in Intensive Care Units. The dominance of carbapenem-resistant A. baumannii and extended-spectrum beta-lactamase-producing and carbapenem-resistant Klebsiella spp. highlights the urgent need for strengthened antimicrobial stewardship, enhanced microbiological surveillance, and reinforced infection prevention strategies.
More Related Videos
Related Concept Videos
Tertiary Healthcare System
Resistivity
Resistance
Equivalent Resistance
Resistance and Conductance
Various factors impact the resistance of a conductor. Spiraling in stranded conductors increases their...
Rolling Resistance
For instance, imagine a hard cylinder rolling on a comparatively soft surface. The cylinder's weight compresses the surface beneath it. As the cylinder moves, the material in front of it slows down due to...


