Six-Year Epidemiologic Analysis of Antibiotic Resistance Patterns of <i>Klebsiella pneumoniae</i> Infections in a Tertiary Healthcare Center in Western Romania
Background and Objectives: <i>Klebsiella pneumoniae</i> is a major nosocomial pathogen with a remarkable ability to develop resistance to multiple antibiotics, posing significant treatment challenges. This study aims to evaluate the antimicrobial resistance patterns among multidrug-resis...
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2024-12-01
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| author | Elena Hogea Alexandra-Cristina Muntean Oana Plavitu Adelina Fratutu Iulia Georgiana Bogdan Felix Bratosin Cristian-Iulian Oancea Septimiu-Radu Susa Daniel Porav-Hodade Mihai-Calin Bica Alexandru Blidisel |
| author_facet | Elena Hogea Alexandra-Cristina Muntean Oana Plavitu Adelina Fratutu Iulia Georgiana Bogdan Felix Bratosin Cristian-Iulian Oancea Septimiu-Radu Susa Daniel Porav-Hodade Mihai-Calin Bica Alexandru Blidisel |
| author_sort | Elena Hogea |
| collection | DOAJ |
| description | Background and Objectives: <i>Klebsiella pneumoniae</i> is a major nosocomial pathogen with a remarkable ability to develop resistance to multiple antibiotics, posing significant treatment challenges. This study aims to evaluate the antimicrobial resistance patterns among multidrug-resistant (MDR) and non-MDR strains of <i>K. pneumoniae</i> isolated over a six-year period (2018–2023) at the Clinical Hospital of Infectious Diseases and Pulmonology “Dr. Victor Babes” in Timisoara, Romania. The objectives include categorizing isolates based on their antibiotic resistance profiles and identifying trends in resistance to key antibiotics to optimize treatment strategies and enhance infection control measures. Materials and Methods: A cross-sectional analysis was conducted on <i>K. pneumoniae</i> isolates obtained from various clinical samples between January 2018 and December 2023. Identification was performed using standard bacteriological procedures, and antimicrobial susceptibility testing was conducted using the Kirby–Bauer disk diffusion method in accordance with EUCAST guidelines. Isolates were classified as susceptible, resistant, MDR, extensively drug-resistant (XDR), or pandrug-resistant (PDR) based on ECDC definitions. Data were analyzed using GraphPad Prism 6, with chi-square tests and Cochran–Armitage trend tests applied where appropriate. Statistical significance was set at <i>p</i> < 0.05. Results: A total of 1,081 <i>K. pneumoniae</i> isolates were identified over the six-year period, increasing from 118 isolates in 2018 to 319 in 2023. The proportion of XDR and PDR strains showed a significant upward trend from 30.5% in 2018 to 57.4% in 2023 (<i>p</i> < 0.001). Specifically, XDR strains increased from 22.9% in 2018 to 39.8% in 2023, while PDR strains rose from 7.6% to 17.6%. Among monomicrobial infections in 2023, XDR and PDR strains accounted for 42.4% and 16.5%, respectively. Resistance to carbapenems also showed a significant increase; for instance, resistance to ertapenem rose from 35.6% in 2018 to 54.2% in 2023 (<i>p</i> < 0.001). Subgroup analysis revealed that isolates from bronchial aspirates had the highest rates of XDR and PDR strains in 2023, at 38.0% and 17.2%, respectively. Additionally, polymicrobial infections where both <i>K. pneumoniae</i> and co-infecting pathogens were XDR/PDR increased from 24.2% in 2018 to 46.6% in 2023 (<i>p</i> < 0.001). Conclusions: The study demonstrates a significant escalation in antimicrobial resistance among <i>K. pneumoniae</i> isolates over the six-year period, particularly in XDR and PDR strains. The rising trend of resistance to critical antibiotics like carbapenems underscores the urgent need for enhanced antimicrobial stewardship and infection control measures. Targeted interventions are essential to curb the spread of these resistant strains and to optimize therapeutic strategies. |
| format | Article |
| id | doaj-art-b09419fe25f04971ab792da792a2fc78 |
| institution | DOAJ |
| issn | 2036-7481 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Microbiology Research |
| spelling | doaj-art-b09419fe25f04971ab792da792a2fc782025-08-20T02:56:56ZengMDPI AGMicrobiology Research2036-74812024-12-011542661267210.3390/microbiolres15040176Six-Year Epidemiologic Analysis of Antibiotic Resistance Patterns of <i>Klebsiella pneumoniae</i> Infections in a Tertiary Healthcare Center in Western RomaniaElena Hogea0Alexandra-Cristina Muntean1Oana Plavitu2Adelina Fratutu3Iulia Georgiana Bogdan4Felix Bratosin5Cristian-Iulian Oancea6Septimiu-Radu Susa7Daniel Porav-Hodade8Mihai-Calin Bica9Alexandru Blidisel10Department XIV, Discipline of Microbiology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaEmergency Clinical County Hospital “Pius Brinzeu”, 300723 Timisoara, RomaniaClinical Hospital of Infectious Diseases and Pulmonology “Dr. Victor Babes”, 300310 Timisoara, RomaniaMunicipal Hospital Lupeni, 335600 Lupeni, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaClinical Hospital of Infectious Diseases and Pulmonology “Dr. Victor Babes”, 300310 Timisoara, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDepartment of Urology, The “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaClinic of Surgical Semiotics and Thoracic Surgery—1, Department IX—Surgery—1, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaBackground and Objectives: <i>Klebsiella pneumoniae</i> is a major nosocomial pathogen with a remarkable ability to develop resistance to multiple antibiotics, posing significant treatment challenges. This study aims to evaluate the antimicrobial resistance patterns among multidrug-resistant (MDR) and non-MDR strains of <i>K. pneumoniae</i> isolated over a six-year period (2018–2023) at the Clinical Hospital of Infectious Diseases and Pulmonology “Dr. Victor Babes” in Timisoara, Romania. The objectives include categorizing isolates based on their antibiotic resistance profiles and identifying trends in resistance to key antibiotics to optimize treatment strategies and enhance infection control measures. Materials and Methods: A cross-sectional analysis was conducted on <i>K. pneumoniae</i> isolates obtained from various clinical samples between January 2018 and December 2023. Identification was performed using standard bacteriological procedures, and antimicrobial susceptibility testing was conducted using the Kirby–Bauer disk diffusion method in accordance with EUCAST guidelines. Isolates were classified as susceptible, resistant, MDR, extensively drug-resistant (XDR), or pandrug-resistant (PDR) based on ECDC definitions. Data were analyzed using GraphPad Prism 6, with chi-square tests and Cochran–Armitage trend tests applied where appropriate. Statistical significance was set at <i>p</i> < 0.05. Results: A total of 1,081 <i>K. pneumoniae</i> isolates were identified over the six-year period, increasing from 118 isolates in 2018 to 319 in 2023. The proportion of XDR and PDR strains showed a significant upward trend from 30.5% in 2018 to 57.4% in 2023 (<i>p</i> < 0.001). Specifically, XDR strains increased from 22.9% in 2018 to 39.8% in 2023, while PDR strains rose from 7.6% to 17.6%. Among monomicrobial infections in 2023, XDR and PDR strains accounted for 42.4% and 16.5%, respectively. Resistance to carbapenems also showed a significant increase; for instance, resistance to ertapenem rose from 35.6% in 2018 to 54.2% in 2023 (<i>p</i> < 0.001). Subgroup analysis revealed that isolates from bronchial aspirates had the highest rates of XDR and PDR strains in 2023, at 38.0% and 17.2%, respectively. Additionally, polymicrobial infections where both <i>K. pneumoniae</i> and co-infecting pathogens were XDR/PDR increased from 24.2% in 2018 to 46.6% in 2023 (<i>p</i> < 0.001). Conclusions: The study demonstrates a significant escalation in antimicrobial resistance among <i>K. pneumoniae</i> isolates over the six-year period, particularly in XDR and PDR strains. The rising trend of resistance to critical antibiotics like carbapenems underscores the urgent need for enhanced antimicrobial stewardship and infection control measures. Targeted interventions are essential to curb the spread of these resistant strains and to optimize therapeutic strategies.https://www.mdpi.com/2036-7481/15/4/176<i>Klebsiella pneumoniae</i>antibiotic resistancecarbapenemasedrug resistanceESBL |
| spellingShingle | Elena Hogea Alexandra-Cristina Muntean Oana Plavitu Adelina Fratutu Iulia Georgiana Bogdan Felix Bratosin Cristian-Iulian Oancea Septimiu-Radu Susa Daniel Porav-Hodade Mihai-Calin Bica Alexandru Blidisel Six-Year Epidemiologic Analysis of Antibiotic Resistance Patterns of <i>Klebsiella pneumoniae</i> Infections in a Tertiary Healthcare Center in Western Romania Microbiology Research <i>Klebsiella pneumoniae</i> antibiotic resistance carbapenemase drug resistance ESBL |
| title | Six-Year Epidemiologic Analysis of Antibiotic Resistance Patterns of <i>Klebsiella pneumoniae</i> Infections in a Tertiary Healthcare Center in Western Romania |
| title_full | Six-Year Epidemiologic Analysis of Antibiotic Resistance Patterns of <i>Klebsiella pneumoniae</i> Infections in a Tertiary Healthcare Center in Western Romania |
| title_fullStr | Six-Year Epidemiologic Analysis of Antibiotic Resistance Patterns of <i>Klebsiella pneumoniae</i> Infections in a Tertiary Healthcare Center in Western Romania |
| title_full_unstemmed | Six-Year Epidemiologic Analysis of Antibiotic Resistance Patterns of <i>Klebsiella pneumoniae</i> Infections in a Tertiary Healthcare Center in Western Romania |
| title_short | Six-Year Epidemiologic Analysis of Antibiotic Resistance Patterns of <i>Klebsiella pneumoniae</i> Infections in a Tertiary Healthcare Center in Western Romania |
| title_sort | six year epidemiologic analysis of antibiotic resistance patterns of i klebsiella pneumoniae i infections in a tertiary healthcare center in western romania |
| topic | <i>Klebsiella pneumoniae</i> antibiotic resistance carbapenemase drug resistance ESBL |
| url | https://www.mdpi.com/2036-7481/15/4/176 |
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