Previous Antibiotic Exposure and Antimicrobial Resistance Patterns of Acinetobacter spp. and Pseudomonas aeruginosa Isolated from Patients with Nosocomial Infections

Balkan Med J. 2017 Dec 1;34(6):527-533. doi: 10.4274/balkanmedj.2016.1844.

Abstract

Background: The alarming spread of antibiotic-resistant bacteria causing healthcare-associated infections has been extensively reported in recent medical literature.

Aims: To compare trends in antimicrobial consumption and development of resistance among isolates of Acinetobacter spp. and Pseudomonas aeruginosa that cause hospital infections.

Study design: Cross-sectional study.

Methods: A study was conducted in a tertiary healthcare institution in central Serbia, during the 7-year period between January 2009 and December 2015. The incidence rate of infections caused by Acinetobacter or Pseudomonas, as well as their resistance density to commonly used antibiotics, were calculated. Utilization of antibiotics was expressed as the number of defined daily doses per 1000 patient-days.

Results: A statistically significant increase in resistance density in 2015 compared to the first year of observation was noted for Acinetobacter, but not for Pseudomonas, to third-generation cephalosporins (p=0.008), aminoglycosides (p=0.005), carbapenems (p=0.003), piperacillin/tazobactam (p=0.025), ampicillin/sulbactam (p=0.009) and tigecycline (p=0.048).

Conclusion: Our study showed that there is an association between the resistance density of Acinetobacter spp. and utilization of carbapenems, tigecycline and aminoglycosides. A multifaceted intervention is needed to decrease the incidence rate of Acinetobacter and Pseudomonas hospital infections, as well as their resistance density to available antibiotics.

Keywords: Acinetobacter antimicrobial resistance.; Nosocomial infections; Pseudomonas aeruginosa.

MeSH terms

  • Acinetobacter / drug effects*
  • Acinetobacter / isolation & purification
  • Acinetobacter Infections / drug therapy
  • Acinetobacter Infections / microbiology*
  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Cross Infection / drug therapy*
  • Cross Infection / microbiology*
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial / drug effects*
  • Humans
  • Microbial Sensitivity Tests
  • Practice Patterns, Physicians' / statistics & numerical data
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / microbiology*
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / isolation & purification
  • Serbia / epidemiology

Substances

  • Anti-Bacterial Agents