IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i19p6943-d417704.html
   My bibliography  Save this article

Characteristics of Microbial Factors of Healthcare-Associated Infections Including Multidrug-Resistant Pathogens and Antibiotic Consumption at the University Intensive Care Unit in Poland in the Years 2011–2018

Author

Listed:
  • Agnieszka Litwin

    (Microbiology Laboratory, University Hospital Wroclaw, 50-556 Wroclaw, Poland)

  • Olga Fedorowicz

    (Department of Clinical Pharmacology, Wroclaw Medical University, 50-367 Wroclaw, Poland)

  • Wieslawa Duszynska

    (Department and Clinic of Anesthesiology and Intensive Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland)

Abstract

Introduction: In recent years, an increase in healthcare-associated infections (HAIs) caused by resistant pathogens, which is a clinically troublesome trend, has been observed. The aim of the study was to analyze the microbial factors of HAIs and the drug resistance of microorganisms to selected antibiotics and their consumption. Material and Methods: The retrospective study included 3708 patients hospitalized in the intensive care unit (ICU) of the University Teaching Hospital in Wroclaw, who were diagnosed with 742 HAIs in the period from 1 January 2011 to 31 December 2018. The aim of the study was the analysis of microorganisms isolated in the respective clinical forms of HAIs, including the occurrence of “alert pathogens”, presence of multidrug-resistant (MDR) strains, and consumption of selected antibiotics. Findings: During the study period, 846 microorganisms were cultured in patients with HAIs, and among them, Acinetobacter baumannii MDR represented 31.8%; Klebsiella pneumoniae ESBLs, 11.3%; Pseudomonas aeruginosa MDR, 4.1% and MRSA, 2.2%; and Enterococcus spp. vancomycin-resistant enterococci (VRE), 1.3%. Among all the pathogens, Gram-negative bacteria (GNB) were dominant (71.6%). Gram-positive bacteria and fungi accounted for 21.6% and 7%, respectively. The total number of strains responsible for ventilator-associated pneumonia (VAP), urinary tract infection (UTI), and central line-associated blood stream infection (CLA-BSI) was as follows: 458 (54.1%), 274 (32.4%), and 114 (13.5%), respectively. Among the etiological factors of VAP, there was a prevalence of A. baumannii MDR (41.9%), as well as in the case of UTI (21.9%). With regards to CLA-BSI, MRCNS (29.8%) was the dominant pathogen. The “alert pathogens” accounted for 54.7% of all the analyzed strains. The MDR strains represented 72.6% and 9.7% among A. baumannii and P. aeruginosa, respectively. In the years 2011 vs. 2018, an increase in infections with MDR bacilli was observed, 34.6% vs. 61.0% ( p = 0.0008), respectively, including A. baumannii MDR 16.54% vs. 34.56 % ( p = 0.0009) and Enterobacterales ESBL+/AMPC 11.8% vs. 15.44 % ( p = 0.3921). Resistance to methicillin was confirmed in 35.2% of S. aureus strains. Resistance to vancomycin was found among 30.9% of Enterococcus spp. The observed period was marked by an increase in the consumption of carbapenems: 197.7 vs. 235.9 defined daily dose (DDD)/1000 patients-days. Conclusions: Gram-negative bacteria were found to be dominant pathogens in healthcare-associated infections. The most frequently cultured pathogens were multidrug-resistant A. baumannii, K. pneumoniae ESBL(+), and P. aeruginosa . The study showed an increase in the incidence of “alert pathogens” and MDR bacilli, as well as the tendency of a growing resistance to antibiotics during the observed period. Microbiological analysis of HAIs and the consumption of antibiotics is the necessary element of the proper antibiotic policy in hospitals.

Suggested Citation

  • Agnieszka Litwin & Olga Fedorowicz & Wieslawa Duszynska, 2020. "Characteristics of Microbial Factors of Healthcare-Associated Infections Including Multidrug-Resistant Pathogens and Antibiotic Consumption at the University Intensive Care Unit in Poland in the Years," IJERPH, MDPI, vol. 17(19), pages 1-14, September.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:19:p:6943-:d:417704
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/19/6943/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/17/19/6943/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Małgorzata Kołpa & Marta Wałaszek & Agnieszka Gniadek & Zdzisław Wolak & Wiesław Dobroś, 2018. "Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland," IJERPH, MDPI, vol. 15(1), pages 1-16, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Andrea J. Grisold & Josefa Luxner & Branka Bedenić & Magda Diab-Elschahawi & Michael Berktold & Agnes Wechsler-Fördös & Gernot E. Zarfel, 2021. "Diversity of Oxacillinases and Sequence Types in Carbapenem-Resistant Acinetobacter baumannii from Austria," IJERPH, MDPI, vol. 18(4), pages 1-10, February.
    2. Agnieszka Chmielarczyk & Monika Pomorska-Wesołowska & Dorota Romaniszyn & Jadwiga Wójkowska-Mach, 2021. "Healthcare-Associated Laboratory-Confirmed Bloodstream Infections—Species Diversity and Resistance Mechanisms, a Four-Year Retrospective Laboratory-Based Study in the South of Poland," IJERPH, MDPI, vol. 18(5), pages 1-13, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Elżbieta Rafa & Marta Z. Wałaszek & Michał J. Wałaszek & Adam Domański & Anna Różańska, 2021. "The Incidence of Healthcare-Associated Infections, Their Clinical Forms, and Microbiological Agents in Intensive Care Units in Southern Poland in a Multicentre Study from 2016 to 2019," IJERPH, MDPI, vol. 18(5), pages 1-12, February.
    2. Agnieszka Chmielarczyk & Monika Pomorska-Wesołowska & Dorota Romaniszyn & Jadwiga Wójkowska-Mach, 2021. "Healthcare-Associated Laboratory-Confirmed Bloodstream Infections—Species Diversity and Resistance Mechanisms, a Four-Year Retrospective Laboratory-Based Study in the South of Poland," IJERPH, MDPI, vol. 18(5), pages 1-13, March.
    3. Anna Szczypta & Katarzyna Talaga-Ćwiertnia & Małgorzata Kielar & Paweł Krzyściak & Anna Gajewska & Mirosław Szura & Małgorzata Bulanda & Agnieszka Chmielarczyk, 2021. "Investigation of Acinetobacter baumannii Activity in Vascular Surgery Units through Epidemiological Management Based on the Analysis of Antimicrobial Resistance, Biofilm Formation and Genotyping," IJERPH, MDPI, vol. 18(4), pages 1-15, February.
    4. Maria Kózka & Aurelia Sega & Katarzyna Wojnar-Gruszka & Agnieszka Tarnawska & Agnieszka Gniadek, 2020. "Risk Factors of Pneumonia Associated with Mechanical Ventilation," IJERPH, MDPI, vol. 17(2), pages 1-7, January.
    5. Małgorzata Kołpa & Marta Wałaszek & Anna Różańska & Zdzisław Wolak & Jadwiga Wójkowska-Mach, 2018. "Hospital-Wide Surveillance of Healthcare-Associated Infections as a Source of Information about Specific Hospital Needs. A 5-Year Observation in a Multiprofile Provincial Hospital in the South of Pola," IJERPH, MDPI, vol. 15(9), pages 1-10, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:19:p:6943-:d:417704. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.