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Trends in antimicrobial resistance among Enterobacter isolates in an Australian local health district
Victoria Maseko1, Colin H Cortie1, Kylie J Mansfield1
1Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia.
Background:
Antimicrobial resistance (AMR) is a universal health issue, causing significant morbidity and mortality. Enterobacter species is a gram-negative bacterial pathogen that has intrinsic and acquired resistance to multiple antibiotic classes.
Aim:
To determine trends in antibiotic resistance among Enterobacter isolates in community and hospital settings within the Illawarra Shoalhaven region of NSW, Australia.
Methods:
We analysed Enterobacter spp. isolates from a hospital-based (N = 2131) and a community-based (N = 1123) laboratory in Illawarra Shoalhaven, between 2007 and 2018. Trimethoprim, gentamicin, tobramycin, amikacin, ciprofloxacin, and meropenem resistance over the 11-y period was determined, and resistance trends and rates between community and hospital settings were compared, using statistical analysis (Pearson's chi-squared tests).
Findings:
AMR was significantly higher in hospital (14.9%) compared to community (8.9%) isolates. AMR reduced over the 11-y period for all antibiotics except amikacin and meropenem, for which resistance remained low throughout.
Conclusions:
Antibiotic resistance in Enterobacter spp. was higher in the hospital setting; however, resistance over time either significantly reduced (for most antibiotics) or remained stable (for some antibiotics) in both groups. The reduction was more pronounced in the hospital setting. This highlights the contribution of hospital-based infection-control measures, including the antimicrobial stewardship program.
Insights
Antimicrobial resistance (AMR) in Enterobacter species was higher in hospitals but decreased over time in both hospital and community settings. Hospital infection control measures likely contributed to this reduction.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance (AMR) poses a global health threat, with Enterobacter species exhibiting significant resistance.
- Enterobacter species are gram-negative bacteria known for intrinsic and acquired resistance to various antibiotics.
Purpose of the Study:
- To analyze antibiotic resistance trends in Enterobacter isolates.
- Compare resistance patterns between community and hospital settings in Illawarra Shoalhaven, NSW, Australia.
- Assess resistance changes over an eleven-year period (2007-2018).
Main Methods:
- Analysis of Enterobacter spp. isolates from hospital (N=2131) and community (N=1123) laboratories.
- Determination of resistance to trimethoprim, gentamicin, tobramycin, amikacin, ciprofloxacin, and meropenem.
- Statistical comparison of resistance trends using Pearson's chi-squared tests.
Main Results:
- Hospital isolates showed higher AMR (14.9%) than community isolates (8.9%).
- Overall AMR decreased over the study period for most tested antibiotics.
- Resistance to amikacin and meropenem remained consistently low.
Conclusions:
- Enterobacter spp. antibiotic resistance is higher in hospitals but shows a decreasing trend.
- Reductions in resistance were more significant in hospital settings.
- Effective hospital infection control and antimicrobial stewardship programs contribute to reduced AMR.
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