Literature DB >> 34907033

Antibiotic utility and susceptibility changes of multidrug-resistant Escherichia coli and Klebsiella spp: 5-year experience in a tertiary healthcare centre.

Radmila Veličković-Radovanović1,2, Nikola Stefanović3, Ivana Damnjanović3, Branislava Kocić3,4, Snežana Mladenović-Antić4, Marina Dinić3,4, Jasmina Petrović2, Radmila Mitić2, Aleksandra Catić-Đorđević3.   

Abstract

OBJECTIVES: Multiple studies have identified cross-sectional relationships between antibiotic use and bacterial resistance. The aim of this study was to analyse the susceptibility of multidrug-resistant (MDR) and non-MDR (nMDR) isolates of Escherichia coli and Klebsiella spp to cephalosporins: ceftazidime (CTZ), ceftriaxone (CTX), cefepime (CEF) and fluoroquinolones: ciprofloxacin (CIP) and levofloxacin (LEV) in a tertiary healthcare centre from 2014 to 2018. In addition, we aimed to evaluate a correlation between the antibiotic utility and susceptibility of the selected enterobacteria.
METHODS: Antibiotics consumption and antimicrobial resistance were monitored in a tertiary care university hospital from 2014 to 2018. Utilisation of antibiotics in the observed period was expressed as defined daily dose (DDD) per 100 bed/days (DBD). Bacterial susceptibility was reported as the percentage of susceptible results among all tested isolates from all patient samples. In further analysis, bacterial strains were considered as MDR or nMDR species. An MDR bacterial strain was defined as one with acquired non-susceptibility to at least one agent in three or more antimicrobial categories.
RESULTS: Our results suggest that cephalosporins were the most used antibiotics, followed by fluoroquinolones, during the entire observed period 2014-2018. Our findings show that MDR isolates of E. coli had an increasing trend in susceptibility in relation to CTX (p=0.005), whereas a decreasing trend was observed for MDR isolates of E. coli susceptibility towards CIP and LEV (p<0.001). Klebsiella spp susceptibility for MDR isolates showed a decreasing trend in relation to CEF (p<0.001) and both fluoroquinolones (p<0.001). A significant negative association between CEF consumption and Klebsiella spp MDR isolates susceptibility was observed (p=0.045).
CONCLUSION: Implementation of antimicrobial stewardship programmes with early detection and close monitoring of MDR bacterial strains of E. coli and Klebsiella spp may be a crucial step in reducing the menace of antimicrobial resistance, which is now a global problem. © European Association of Hospital Pharmacists 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Entities:  

Keywords:  clinical medicine; hospital; microbiology; pharmacy service; public health; quality of health care

Mesh:

Substances:

Year:  2021        PMID: 34907033      PMCID: PMC8899649          DOI: 10.1136/ejhpharm-2021-002758

Source DB:  PubMed          Journal:  Eur J Hosp Pharm        ISSN: 2047-9956


  22 in total

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10.  Eight-year trends in the relative isolation frequency and antimicrobial susceptibility among bloodstream isolates from Greek hospitals: data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance - WHONET-Greece, 2010 to 2017.

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Journal:  Euro Surveill       Date:  2020-08
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