EPISIOTOMY INFECTIONS IN THE PUERPERIUM AND ANTIMICROBIAL RESISTANCE OF RESPONSIBLE PATHOGENS IN UKRAINE

2020 ◽  
Vol 73 (11) ◽  
pp. 2325-2331
Author(s):  
Aidyn G. Salmanov ◽  
Taras G. Voitok ◽  
Igor V. Maidannyk ◽  
Serhiy Yu. Vdovychenko ◽  
Olena О. Chorna ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Vaginal Delivery ◽  
Prevalence Rate ◽  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Resistant Bacteria ◽  
Esbl Production ◽  
Multicenter Cohort Study ◽  
Klebsiella Spp

1 2 ABSTRACT The aim: To obtain the first estimates of the current prevalence rate of episiotomy infections in the puerperium and antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data. The study population consisted of all women who had a vaginal delivery in 7 Regional Women’s Hospitals of Ukraine. Definitions of episiotomy infections were used from the Centers for Disease Control and Prevention’s National Healthcare Safety Network (CDC/NHSN). Results: Total 35.6% women after vaginal delivery had episiotomy done. The prevalence rate of episiotomy infections was 17.7%. The predominant pathogens were: Escherichia coli (49.2%), Enterobacter spp. (11.1%), Streptococcus spp. (9.1%), Enterococcus faecalis (6.5%), Klebsiella spp. (8.1%), followed by Pseudomonas aeruginosa (4.7%), Staphylococcus aureus (4.2%), Proteus spp.(2.9%) and Staphylococcus epidermidis (2.8%). The overall proportion of methicillin-resistance was observed in 17.3% of Staphylococcus aureus (MRSA). Vancomycin resistance was observed in 6.8% of isolated enterococci. Carbapenem resistance was identified in 8% of P.aeruginosa isolates. Resistance to third-generation cephalosporins was observed in 15.2% Klebsiella spp. and E.coli 16.4% isolates. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 26.4%. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (31.4%, vs 12.5%). Conclusions: Episiotomy infections in the puerperium are common in Ukraine and most of these infections caused by antibiotic-resistant bacteria. Optimizing the management and empirical antimicrobial therapy may reduce the burden of episiotomy infections, but prevention is the key element.

VAGINAL CUFF INFECTION AFTER HYSTERECTOMY IN UKRAINE

2021 ◽  
Vol 74 (2) ◽  
pp. 196-201
Author(s):  
Aidyn G. Salmanov ◽  
Alla D. Vitiuk ◽  
Solomiia Ya. Hrynchuk ◽  
Anna S. Bober ◽  
Oksana B. Hrynchuk ◽  
...  
Keyword(s):  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Laparoscopic Hysterectomy ◽  
Resistant Bacteria ◽  
Esbl Production ◽  
Vaginal Cuff ◽  
Multicenter Cohort Study ◽  
Beta Lactamases ◽  
Current Prevalence ◽  
Extended Spectrum Beta Lactamases

The aim: To obtain the first estimates of the current prevalence of vaginal cuff infection after hysterectomy and antimicrobial resistance of causing pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data. The study population consisted of women who had an abdominal, vaginal or laparoscopic hysterectomy from 2017 to 2019 in 7 women hospitals of Ukraine. Definitions of vaginal cuff infections were used from the Centers for Disease Control and Prevention’s National Healthcare Safety Network, USA. Results: Total 12.6% women’s after hysterectomy had vaginal cuff infections. Of these cases, 20.3% after abdominal, 15.5% vaginal and 4.1% laparoscopic hysterectomy were identified. The predominant pathogens of VCUF infections were: Escherichia coli (18.6%), Enterobacter spp. (12.4%), Staphylococcus aureus (10.8%), Streptococcus spp. (9,7%), Klebsiella pneumoniae (8.2%), Pseudomonas aeruginosa (7.6%), Enterococcus faecalis (7,0%) and Proteus spp. (7.0%). Methicillin-resistance was observed in 12.9% of S. aureus (MRSA) and 9.7% CoNS. Carbapenem resistance was identified in 7.3% of P.aeruginosa isolates. Resistance to thirdgeneration cephalosporins was observed in 8.9% K. pneumoniae and E.coli 11.9% isolates. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 22.7%. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (32.6%, vs 12.3%). Conclusions: Vaginal cuff infections in women after hysterectomy are common in Ukraine and most of these infections caused by antibiotic-resistant bacteria. The incidence of VCUF infections after hysterectomy differs depending on the type of surgical procedure.

scholarly journals POSTPARTUM MASTITIS IN THE BREASTFEEDING WOMEN AND ANTIMICROBIAL RESISTANCE OF RESPONSIBLE PATHOGENS IN UKRAINE: RESULTS A MULTICENTER STUDY

2020 ◽  
Vol 73 (5) ◽  
pp. 895-903
Author(s):  
Aidyn G. Salmanov ◽  
Serhii E. Savchenko ◽  
Kyrylo Chaika ◽  
Alla D. Vitiuk ◽  
Iana Ruban ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Hospital Discharge ◽  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Medical Attention ◽  
Multicenter Cohort Study ◽  
Healthcare Associated ◽  
Regional Hospitals ◽  
Third Generation Cephalosporins ◽  
Klebsiella Spp

The aim: To obtain the prevalence of mastitis in the breastfeeding women and antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: A retrospective multicenter cohort study was based on surveillance data for Postpartum Mastitis and included 18,427 breastfeeding women’s who gave birth in 11 regional hospitals of Ukraine. Results: 22.6% breastfeeding women’s were found to have breast infections. Among these patients, 11.6% breast abscess and 88.4% mastitis were observed. Of the total cases breast infections, 74.8% were detected after hospital discharge. The rate of healthcare-associated mastitis was 8.6%. The predominant pathogens were: Staphylococcus aureus (23.6%), Escherichia coli (19.4%), Enterobacter spp. (11.9%), Staphylococcus epidermidis (10.7%), Klebsiella spp. (8.7%), Pseudomonas aeruginosa (4.8%), Enterococcus faecalis (4.8%), and Proteus mirabilis (4.6%). The overall proportion of methicillin-resistance was observed in 27.9% of S. aureus (MRSA) and 24.3% of S. epidermidis (MRSE). Of the total methicillin-resistance strains, 74.8% of MRSA and 82.1% of MRSE is community-acquired, were detected after hospital discharge. Vancomycin resistance was observed in 9.2% of isolated enterococci. Carbapenem resistance was identified in 7.3% of P.aeruginosa isolates. Resistance to third-generation cephalosporins was observed in 8.8% Klebsiella spp. and E.coli 9.1% isolates. Conclusions: Mastitis in the breastfeeding women in Ukraine requires medical attention it is common, and a lot of cases are caused by pathogens resistant to antibiotics. Optimizing the management and empirical antimicrobial therapy may reduce the burden of mastitis, but prevention is the key element.

scholarly journals Antimicrobial Resistance and the Spectrum of Pathogens in Dental and Oral-Maxillofacial Infections in Hospitals and Dental Practices in Germany

2021 ◽  
Vol 12 ◽  
Author(s):  
Annika Meinen ◽  
Annicka Reuss ◽  
Niklas Willrich ◽  
Marcel Feig ◽  
Ines Noll ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Control Measures ◽  
Clinical Isolates ◽  
Infection Prevention And Control ◽  
Odontogenic Infections ◽  
Hospital Patients ◽  
Dental Practices

Data on microbiological profiles in odontogenic infections are scarce. This study aimed to analyze the spectrum of pathogens and antimicrobial resistance in clinical isolates from dental and oral-maxillofacial clinical settings in Germany. We analyzed 20,645 clinical isolates (dental practices: n = 5,733; hospitals: n = 14,912) from patients with odontogenic infections using data (2012–2019) from the German Antimicrobial-Resistance-Surveillance (ARS) system. A total of 224 different species from 73 genera were found in clinical isolates from dental practices, and 329 different species from 97 genera were identified in isolates from hospital patients. In both hospitals and dental practices Streptococcus spp. (33 and 36%, respectively) and Staphylococcus spp. (21 and 12%, respectively) were the most frequently isolated microorganisms. In Streptococcus spp. isolates from hospitals, penicillin and aminopenicillin resistance proportions were 8.0% (95%CI 4.7–14.9%) and 6.9% (95%CI 4.7–9.9%), respectively. Substantially lower resistance proportions of penicillin and aminopenicillin were observed in dental practices [2.6% (95%CI 1.4–4.7%) and 2.1% (95%CI 1.1–4.0%), respectively]. Among Staphylococcus aureus isolates from hospital patients methicillin resistance proportions were 12.0% (95%CI 9.7–14.8%), which was higher than in isolates from dental practices (5.8% (95%CI 4.1–8.1%)]. High clindamycin and macrolide resistance proportions (>17%) were observed in Streptococcus spp. and Staphylococcus aureus isolates. In Klebsiella spp. isolates carbapenem resistance proportions were <1%. In sum, substantial antibiotic resistance was observed in isolates from odontogenic infections, which calls for strengthened efforts in antibiotic stewardship and infection prevention and control measures in both hospitals and dental practices.

scholarly journals HEALTHCARE ASSOCIATED DEEP PELVIC TISSUE INFECTION AND OTHER INFECTIONS OF THE FEMALE REPRODUCTIVE TRACT IN UKRAINE

2021 ◽  
Vol 74 (3) ◽  
pp. 406-412
Author(s):  
Aidyn G. Salmanov ◽  
Lidiya V. Suslikova ◽  
Svitlana A. Pandei ◽  
Victor O. Rud ◽  
Igor V. Kokhanov ◽  
...  
Keyword(s):  
Reproductive Tract ◽  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Pelvic Abscess ◽  
Female Reproductive Tract ◽  
Tissue Infection ◽  
Esbl Production ◽  
Multicenter Cohort Study ◽  
Reproductive Tract Infection ◽  
Healthcare Associated

The aim: To obtain the first estimates of the current prevalence of healthcare-associated deep pelvic tissue infection and other infections of the female reproductive tract (vagina, ovaries, uterus) including chorioamnionitis, and antimicrobial resistance of causing pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data. The study population included 3,053 women’s who underwent gynecological surgery or other procedures from 2017 to 2019 in 7 women hospitals in Ukraine. Definitions of healthcare-associated reproductive tract infection were used from the CDC/ NHSN. Results: The prevalence of healthcare-associated deep pelvic tissue infection and other infections of the female reproductive tract was 26.3%. Incidence of infection was: 13.3% Pelvic abscess or cellulitis, 14.6% Adnexa utery, 9.5% Salpingitis, 7.1% Oophoritis, 12.2% Parametritis, 4.6% Chorioamnionitis, and 38.8% Bacterial Vaginitis. The predominant pathogens were: Escherichia coli (25.6%), Enterobacter spp. (11.4%), Klebsiella pneumoniae (10.6%), Staphylococcus aureus (8.5%), Enterococcus faecalis (7.2%) and Pseudomonas aeruginosa (7.1%). Methicillin-resistance was observed in 14.3% of S. aureus (MRSA). The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 20.8%. The prevalence of ESBL production among E. coli isolates was 24.7% and among K. pneumoniae 11.9%. Resistance to thirdgeneration cephalosporins was observed in 12.8% E.coli and 9.2% K. pneumoniae isolates. Carbapenem resistance was identified in 8.5% of P.aeruginosa isolates. Conclusions: Healthcare associated deep pelvic tissue infection and other infections of the female reproductive tract in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics.

scholarly journals PREVALENCE OF POSTPARTUM ENDOMETRITIS AND ANTIMICROBIAL RESISTANCE OF RESPONSIBLE PATHOGENS IN UKRAINE: RESULTS A MULTICENTER STUDY (2015-2017)

2020 ◽  
Vol 73 (6) ◽  
pp. 1177-1183
Author(s):  
Aidyn G. Salmanov ◽  
Alla D. Vitiuk ◽  
Dmytro Zhelezov ◽  
Olga Bilokon ◽  
Alla G. Kornatska ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Antimicrobial Agents ◽  
Methicillin Resistance ◽  
Mode Of Delivery ◽  
Multicenter Cohort Study ◽  
Hospital System ◽  
Vaginal Deliveries

The aim: To obtain the prevalence of postpartum endometritis women and antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study. The study population consisted of all women who had a vaginal delivery or cesarean section in 14 Regional Women’s Hospitals of Ukraine. Results: Total 2460 of 25,344 patients were found to have postpartum endometritis, for an overall infection rate of 9.7%. The postpartum endometritis rates were 7.6% after vaginal delivery and 16.4% after cesarean section. Incidence of postpartum endometritis after cesarean section is affected mainly by the mode of delivery (scheduled caesarean deliveries (done before labor starts) – 13.8% and unscheduled caesarean deliveries (done after labor starts) – 22.5%. The predominant pathogens were: Escherichia coli (32.7%), Enterococcus faecalis (13.0%), Streptococcus spp. (12.1%), Klebsiella spp. (10.4%) and Enterobacter spp. (10%). Among the antimicrobial agents tested, the ertapenem, piperacillin/ tazobactam, and cefotaxim were the most consistently active in vitro against Enterobacteriaceae in both vaginal deliveries and after cesarean section infections. The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 22.8% and of methicillin-resistance in Staphylococcus aureus (MRSA) 15.4%. Conclusions: Postpartum endometritis and antimicrobial resistance of responsible pathogens presents a significant burden to the hospital system. Postpartum infections surveillance is required in all women’s hospitals. This knowledge is essential to develop targeted strategies to reduce the incidence of postpartum infections.

The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection

2021 ◽  
pp. 153473462110041
Author(s):  
Nese Saltoglu ◽  
Serkan Surme ◽  
Elif Ezirmik ◽  
Ayten Kadanali ◽  
Ahmet Furkan Kurt ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Antimicrobial Resistance ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Initial Treatment ◽  
Methicillin Resistance ◽  
Major Amputation ◽  
Diabetic Foot Infection ◽  
Vascular Insufficiency ◽  
Klebsiella Spp

We aimed to determine pathogen microorganisms, their antimicrobial resistance patterns, and the effect of initial treatment on clinical outcomes in patients with diabetic foot infection (DFI). Patients with DFI from 5 centers were included in this multicenter observational prospective study between June 2018 and June 2019. Multivariate analysis was performed for the predictors of reinfection/death and major amputation. A total of 284 patients were recorded. Of whom, 193 (68%) were male and the median age was 59.9 ± 11.3 years. One hundred nineteen (41.9%) patients had amputations, as the minor (n = 83, 29.2%) or major (n = 36, 12.7%). The mortality rate was 1.7% with 4 deaths. A total of 247 microorganisms were isolated from 200 patients. The most common microorganisms were Staphylococcus aureus (n = 36, 14.6%) and Escherichia coli (n = 32, 13.0%). Methicillin resistance rates were 19.4% and 69.6% in S aureus and coagulase-negative Staphylococcus spp., respectively. Multidrug-resistant Pseudomonas aeruginosa was detected in 4 of 22 (18.2%) isolates. Extended-spectrum beta-lactamase-producing Gram-negative bacteria were detected in 20 (38.5%) isolates of E coli (14 of 32) and Klebsiella spp. (6 of 20). When the initial treatment was inappropriate, Klebsiella spp. related reinfection within 1 to 3 months was observed more frequently. Polymicrobial infection ( p = .043) and vancomycin treatment ( p = .007) were independent predictors of reinfection/death. Multivariate analysis revealed vascular insufficiency ( p = .004), hospital readmission ( p = .009), C-reactive protein > 130 mg/dL ( p = .007), and receiving carbapenems ( p = .005) as independent predictors of major amputation. Our results justify the importance of using appropriate narrow-spectrum empirical antimicrobials because higher rates of reinfection and major amputation were found even in the use of broad-spectrum antimicrobials.

scholarly journals ESBL Activity, MDR, and Carbapenem Resistance among Predominant Enterobacterales Isolated in 2019

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 744
Author(s):  
Altaf Bandy ◽  
Bilal Tantry
Keyword(s):  
Escherichia Coli ◽  
Saudi Arabia ◽  
Antimicrobial Resistance ◽  
Carbapenem Resistance ◽  
Resistant Bacteria ◽  
Sociodemographic Characteristics ◽  
Chi Square ◽  
E Coli ◽  
Chi Square Test ◽  
Resistance Rates

Antimicrobial-resistance in Enterobacterales is a serious concern in Saudi Arabia. The present study retrospectively analyzed the antibiograms of Enterobacterales identified from 1 January 2019 to 31 December 2019 from a referral hospital in the Aljouf region of Saudi Arabia. The revised document of the Centers for Disease Control (CDC) CR-2015 and Magiorakos et al.’s document were used to define carbapenem resistance and classify resistant bacteria, respectively. The association of carbapenem resistance, MDR, and ESBL with various sociodemographic characteristics was assessed by the chi-square test and odds ratios. In total, 617 Enterobacterales were identified. The predominant (n = 533 (86.4%)) isolates consisted of 232 (37.6%), 200 (32.4%), and 101 (16.4%) Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis, respectively. In general, 432 (81.0%) and 128 (24.0%) isolates were of MDR and ESBL, respectively. The MDR strains were recovered in higher frequency from intensive care units (OR = 3.24 (1.78–5.91); p < 0.01). E. coli and K. pneumoniae resistance rates to imipenem (2.55 (1.21–5.37); p < 0.01) and meropenem (2.18 (1.01–4.67); p < 0.04), respectively, were significantly higher in winter. The data emphasize that MDR isolates among Enterobacterales are highly prevalent. The studied Enterobacterales exhibited seasonal variation in antimicrobial resistance rates towards carbapenems and ESBL activity.

Fluoroquinolone- and Methicillin-Resistant Staphylococcus Aureus: Insights from the Antimicrobial Resistance Management Program

2005 ◽  
Vol 21 (3) ◽  
pp. 123-128 ◽  
Author(s):  
John G Gums ◽  
Benjamin J Epstein
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Methicillin Resistance ◽  
Resistance Management ◽  
Multidrug Resistant ◽  
Management Program ◽  
Methicillin Resistant ◽  
The North ◽  
The Us ◽  
Northeast Us

Background: Staphylococcus aureus is a frequent cause of infections involving the bloodstream, skin and soft tissue, and lungs in hospitalized patients. These isolates are often multidrug resistant and represent a major therapeutic challenge. Objective: To explore the susceptibilities of S. aureus to nafcillin/oxacillin, a surrogate for methicillin resistance, and the fluoroquinolones and determine whether a relationship might exist between fluoroquinolone use and the prevalence of methicillin-resistant S. aureus (MRSA). Methods: To date, 353 institutions throughout the US and Puerto Rico have enrolled in the Antimicrobial Resistance Management (ARM) Program, and data have been submitted on nearly 5 million isolates of S. aureus. Isolates submitted from 1990 through 2002 were reviewed for sensitivity to nafcillin/oxacillin, clindamycin, erythromycin, and the fluoroquinolones ciprofloxacin and levofloxacin. Results: From 1990 through 2002 inclusive, susceptibility to nafcillin/oxacillin nationally was 64.9% (n = 360,460), ranging from 62.2% in the North Central and Northeast US to 72.8% in the Southwest. Nationally, S. aureus isolates were more resistant to levofloxacin (41.4%, n = 123,868) than ciprofloxacin (38.7%, n = 256,178). The greatest change in susceptibility of S. aureus to nafcillin/oxacillin and ciprofloxacin occurred concurrently from 1998 to 2002, which may implicate fluoroquinolone use with increasing rates of MRSA infection. Conclusions: Resistance to methicillin and the fluoroquinolones has increased in concert during the past 5 years. Collectively, data from the ARM Program, along with several other investigations, support a role of fluoroquinolone use in the emergence of MRSA. These observations, along with increasing resistance among gram-positive and gram-negative pathogens, underscore the need for judicious use of fluoroquinolones.

scholarly journals 1439. High Rates of Drug Resistance in Escherichia coli from a Pilot Antimicrobial Resistance Surveillance System in Cambodia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S723-S724
Author(s):  
Vandarith Nov ◽  
Darapheak Chau ◽  
Chhorvann Chhea
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Klebsiella Pneumoniae ◽  
Surveillance System ◽  
Methicillin Resistance ◽  
Salmonella Typhi ◽  
Blood Samples

Abstract Background Antimicrobial resistance (AMR) is a major and growing global public health problem. The Cambodia Ministry of Health established a pilot laboratory-based AMR surveillance system for blood specimens in 2017. The objective of this study is to characterize AMR among pathogenic isolates from blood samples. Methods A retrospective analysis was performed using one year of data from a pilot AMR Surveillance system in Cambodia. Four blood culture isolate pathogens were included: Escherichia coli, Klebsiella pneumoniae, Salmonella Typhi /Salmonella Paratyphi A and Staphylococcus aureus. Blood culture isolates that were referred from eleven sentinel sites were analyzed at the National Public Health Laboratory for identification. Antibiotic susceptibility testing (AST) was done using disk diffusion, minimum inhibitory concentration method following Clinical Laboratory Standard Institute (CLSI) guidelines. Results Among 214 pathogenic isolates from blood samples, E.coli was the most common (56.1%), followed by Salmonella Typhi/Salmonella Paratyphi A (18.7%), Staphylococcus aureus (13.5%), and Klebsiella pneumoniae (11.7%). Methicillin Resistance Staphylococcus aureus (MRSA) was detected in half of the isolates. E.coli was resistant to ampicillin (94.4%), trimethoprim-sulfamethoxazole (84.5%), and ceftriaxone (79.2%). Salmonella Typhi was resistant to ampicillin (73.3%) and trimethoprim-sulfamethoxazole (60.0%) and Salmonella Paratyphi A were resistant to fluoroquinolones (91.7%). For last resort antibiotics, E.coli was resistant to carbapenem groups (3.2% for imipenem, 4.9% for meropenem, and 5.0% for ertapenem). Klebsiella pneumoniae was not resistant to any groups. Conclusion E.coli was found at high rates in blood samples and was resistant to common antibiotics used in Cambodia. These pilot data show the importance of establishing a national AMR surveillance system in Cambodia to monitor AMR trends following GLASS guidelines. Disclosures All Authors: No reported disclosures

scholarly journals Antimicrobial resistance profiles of microorganisms isolated from hospitalized patients in Dominican Republic

2020 ◽  
Vol 44 ◽  
pp. 1
Author(s):  
David de Luna ◽  
José Javier Sánchez ◽  
Miguel Peguero ◽  
Wilmary García ◽  
Sylmari Liciaga ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Dominican Republic ◽  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Generation Cephalosporin ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional ◽  
Acinetobacter Spp

Objective. To define the antimicrobial resistance profiles of the microorganisms most commonly isolated from hospitalized adult patients in Dominican Republic (DR). Methods. A retrospective, cross-sectional study of phenotypic antimicrobial susceptibility patterns was conducted using data from 3 802 clinical microbiology reports specifying positive bacterial cultures in samples collected from patients admitted to the clinical, surgery, and intensive care units (ICU) at three tertiary-level care hospitals in the city of Santiago de los Caballeros from 1 January 2016 – 31 December 2017. Descriptive statistics and chi-square test (P ≤ 0.05) were used to analyze the qualitative variables. Results. At the three hospitals, there were 932, 1 090, and 1 780 microbiology reports analyzed. Of the total, 1274 were from the ICU, 1 042 from the surgery unit, and 1 486 from the clinical unit. Methicillin resistance was found in 57.3% of the Staphylococcus aureus isolates and 75.3% of the coagulase-negative staphylococci. Third-generation cephalosporin resistance was detected in 54.4% of isolates identified as members of the Enterobacteriaceae family, 67.3% of the Acinetobacter spp., and 91.7% of the Pseudomonas, while carbapenem resistance was shown by 8.0%, 23.8%, and 51.0% of these, respectively. Most of the resistant Acinetobacter spp. isolates were found in just one hospital and the prevalence of Enterobacteriaceae resistant to carbapenems was highest in the ICU. Conclusion. Antimicrobial resistance levels are high among hospitalized patients in Dominican Republic and may cause enhanced risk factors that impact clinical outcomes. Urgent measures are needed to address antimicrobial resistance in DR.

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