A Ten Years Study of The Rates and Resistance Trends of the ESKAPE Bacteria Isolated from Sterile Body Sites (2010 – 2019) at a Single Hospital

Authors

  • Jamal Wadi Al Ramahi M.D, FIDSA Office 11, The Medical Center, Jordan Hospital and medical Center. 29 Adeeb Wahbeh StreetAmman - Jordan 11118
  • Walid Jamal University of Jordan, School of Medicine

DOI:

https://doi.org/10.3823/847

Keywords:

ESKAPE, Carbapenem-resistant enterobacteriaceae, Carbapenem-resistant P. aeruginosa, Carbapenem-resistant A. baumannii, resistance trends, Extended-spectrum β-lactamases producers

Abstract

Background

To assess the rates and trends of resistance among ESKAPE pathogens during 2010 – 2019.

Methods

A retrospective, single-center study between 2010 –2019, non-duplicate isolates from six sterile sources were studied. Pathogens were processed through the  automated VITEK-2. The Clinical Laboratory Standards Institute (CLSI) breakpoints were referenced. The aim was to detect the rates and resistance trends of the ESKAPE pathogens, the rates of  ESBL-producing K. pneumoniae, and the carbapenem-resistant (CR)-K. pneumoniae, CRAb, CRPa, VRE, and MRSA for the inpatients. Trends for the prevalence and resistance rates were analyzed by linear regression. Missing values were averaged based on the neighboring values. Data analysis was by SPSS version 25, and statistical significance is considered for one-tailed P < 0.05.

Results

The ESKAPE bacteria (4286 isolate) comprised (45.57%) of the inpatients' isolates, the sterile sources consisted of 1421 (33.15%): K. pneumonia 272 isolates, the ESBL-producing K. pneumoniae significantly declined (Pearson R - 0.877, P = 0.001), CR-K. pneumoniae showed no significant trends (P = 0.475). P. aeruginosa 202 isolates; resistance to carbapenem (CRPa) averaged 42%. S. aureus 198 isolates; MRSA rates averaged 45%. A. baumannii 165 isolates; carbapenem-resistance (CRAb) average 93%. Vancomycin-resistant (VR)E. Faecium = 33%, and VRE. faecalis = 15% with a weighted average 17%. Enterobacter spp. resistance rates were: Amikacin 3.6%, Third and fourth generation cephalosporines 28% and 20% respectively, Quinolones 27% ± 3%, Piperacillin/tazobactam resistance 29%, Imipenem 15%, and Meropenem 27.

Conclusion

The ESKAPE pathogens were highly resistant, making treatment more complicated, and compromise the initial empiric treatment.

 

Author Biography

Jamal Wadi Al Ramahi M.D, FIDSA, Office 11, The Medical Center, Jordan Hospital and medical Center. 29 Adeeb Wahbeh StreetAmman - Jordan 11118

Adjunct, Assistant Professor of Infectious Diseases, School of Medicine. University of Jordan

Chairman, The Infection Prevention and Control Committee. Al Khalidi Hospital and Medical Center.

References

- Founou RC, Founou LL, Essack SY. Clinical and economic impact of antibiotic resistance in developing countries: a systematic review and meta-analysis. PloS one. 2017;12(12).

- Keen III EF, Robinson BJ, Hospenthal DR, Aldous WK, Wolf SE, Chung KK, Murray CK. Prevalence of multidrug-resistant organisms recovered at a military burn center. Burns. 2010 Sep 1;36(6):819-25.

- Wadi JA, Alastal Y, Tayyem H, Moh’d J AH. Treatment of combat-related traumatic chronic osteomyelitis with tigecycline: a case series. The International Arabic Journal of Antimicrobial Agents. 2013 Oct 19;3(3).

- Miyazaki M, Yamada Y, Matsuo K, Komiya Y, Uchiyama M, Nagata N, Takata T, Jimi S, Imakyure O. Change in the Antimicrobial Resistance Profile of Extended-Spectrum β-Lactamase-Producing Escherichia coli. Journal of clinical medicine research. 2019 Sep;11(9):635.

- Hsu LY, Apisarnthanarak A, Khan E, Suwantarat N, Ghafur A, Tambyah PA. Carbapenem-resistant Acinetobacter baumannii and Enterobacteriaceae in south and southeast Asia. Clinical microbiology reviews. 2017 Jan 1;30(1):1-22.

- Pfaller MA, Huband MD, Streit JM, Flamm RK, Sader HS. Surveillance of tigecycline activity tested against clinical isolates from a global (North America, Europe, Latin America and Asia-Pacific) collection (2016). International journal of antimicrobial agents. 2018 Jun 1;51(6):848-53.

- Ruh E, Gazi U, Guvenir M, Suer K, Çakır N. Antibiotic resistance rates of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae isolated from a university-affiliated hospital in North Cyprus. Turk Hij Den Biyol Derg. 2016 May 26;73:333-44.

- Labarca JA, Salles MJ, Seas C, Guzmán-Blanco M. Carbapenem resistance in Pseudomonas aeruginosa and Acinetobacter baumannii in the nosocomial setting in Latin America. Critical reviews in microbiology. 2016 Mar 3;42(2):276-92.

- Patel TS, Marshall V, Kaye KS, Smith A, Young C, Lephart P, Pogue JM. 1600. Susceptibility of β-Lactam-Resistant Pseudomonas aeruginosa to Other β-Lactams: Is There Truly a Lack of Cross-Resistance?. InOpen Forum Infectious Diseases 2019 Oct 2 (Vol. 6).

- Liao F, Wang H, Liu X, Wang Q, Tian S, Chu Y. Antimicrobial Resistance of Staphylococcus aureus in Our Hospital over the Last 10 Years. Journal of China Medical University. 2018 Jan 1;47(1):42-7.

- Hagstrand Aldman M, Skovby A, I. PÃ¥hlman L. Penicillin-susceptible Staphylococcus aureus: susceptibility testing, resistance rates and outcome of infection. Infectious diseases. 2017 Jun 3;49(6):454-60.

- Kilbas I, Ciftci IH. Antimicrobial resistance of Enterococcus isolates in Turkey: A meta-analysis of current studies. Journal of global antimicrobial resistance. 2018 Mar 1;12:26-30.

Downloads

Published

2020-10-19

Issue

Vol. 10 No. 2 (2020)

Section

Articles

License

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access and Benefits of Publishing Open Access).

This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.

Articles are published Under License of Creative Commons Attribution 3.0 License ©

 

Copyright policies & self-archiving

This is our Copyright Policy. We are a RoMEO green journal.

Author's Pre-print: green tick  author can archive pre-print (ie pre-refereeing)
Author's Post-print: green tick  author can archive post-print (ie final draft post-refereeing)
Publisher's Version/PDF: green tick  author can archive publisher's version/PDF

 

 

Most read articles by the same author(s)