Seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients: insights from a 7-Year study
Abstract Background Antimicrobial resistance (AMR) is a growing global health challenge, particularly in specialized tertiary care settings. Despite its significance, data on the effects of seasonal variations, demographics, and healthcare settings on AMR in Pakistan are scarce. Aim This study aimed...
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BMC
2025-07-01
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| Online Access: | https://doi.org/10.1186/s12879-025-11171-3 |
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| author | Muhammad Umer Asghar Arsalan Haseeb Zaidi Muhammad Tariq Noor Ul Ain |
| author_facet | Muhammad Umer Asghar Arsalan Haseeb Zaidi Muhammad Tariq Noor Ul Ain |
| author_sort | Muhammad Umer Asghar |
| collection | DOAJ |
| description | Abstract Background Antimicrobial resistance (AMR) is a growing global health challenge, particularly in specialized tertiary care settings. Despite its significance, data on the effects of seasonal variations, demographics, and healthcare settings on AMR in Pakistan are scarce. Aim This study aimed to evaluate the prevalence and resistance patterns of AMR and identify the key contributing factors at a cardiac hospital in Faisalabad from 2012 to 2019 to inform targeted infection control strategies. Methodology This retrospective cross-sectional analysis of 3,035 patient records adhered to STROBE guidelines. AMR profiles, including the multiple antibiotic resistance (MAR) index and antibiotic resistance genes (ARGs), were examined in relation to seasonality, hospital settings, and patient demographics. Results This study identified Staphylococcus aureus, Klebsiella pneumoniae, and Escherichia coli as the most prevalent pathogens, with S. aureus and K. pneumoniae classified among the ESKAPE group (Enterococcus faecium, S. aureus, K. pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.). Isolation rates were higher in inpatients (IPs) than outpatients (OPs), with peak occurrences in autumn and winter among IPs and in spring among OPs. Age and sex significantly influenced pathogen isolation rates. The multiple antibiotic resistance (MAR) index was highest for S. aureus isolates between 2017 and 2019, which showed complete resistance to vancomycin and oxacillin. Key resistance genes mecA, vanA, tetM, and aph(3') were frequently co-detected in S. aureus. Polymyxin B and colistin remained the most effective antibiotics against multidrug-resistant (MDR) strains. Conclusion These findings highlight the critical need for year-round AMR surveillance, with an enhanced focus during seasonal peaks, particularly for high-risk IPs in winter and autumn. Implementing localized antimicrobial stewardship programs (ASPs) and robust infection control measures is essential to reduce the AMR burden and curb its spread in inpatient settings, especially in resource-constrained healthcare systems, such as Pakistan. |
| format | Article |
| id | doaj-art-d7b34328299640bdbdb24354729e4d19 |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-d7b34328299640bdbdb24354729e4d192025-08-20T03:04:22ZengBMCBMC Infectious Diseases1471-23342025-07-0125111710.1186/s12879-025-11171-3Seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients: insights from a 7-Year studyMuhammad Umer Asghar0Arsalan Haseeb Zaidi1Muhammad Tariq2Noor Ul Ain3National Probiotic Lab, National Institute for Biotechnology and Genetic Engineering-College (NIBGE-C)National Probiotic Lab, National Institute for Biotechnology and Genetic Engineering-College (NIBGE-C)National Probiotic Lab, National Institute for Biotechnology and Genetic Engineering-College (NIBGE-C)Centre for Clinical Microbiology, University College London (UCL)Abstract Background Antimicrobial resistance (AMR) is a growing global health challenge, particularly in specialized tertiary care settings. Despite its significance, data on the effects of seasonal variations, demographics, and healthcare settings on AMR in Pakistan are scarce. Aim This study aimed to evaluate the prevalence and resistance patterns of AMR and identify the key contributing factors at a cardiac hospital in Faisalabad from 2012 to 2019 to inform targeted infection control strategies. Methodology This retrospective cross-sectional analysis of 3,035 patient records adhered to STROBE guidelines. AMR profiles, including the multiple antibiotic resistance (MAR) index and antibiotic resistance genes (ARGs), were examined in relation to seasonality, hospital settings, and patient demographics. Results This study identified Staphylococcus aureus, Klebsiella pneumoniae, and Escherichia coli as the most prevalent pathogens, with S. aureus and K. pneumoniae classified among the ESKAPE group (Enterococcus faecium, S. aureus, K. pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.). Isolation rates were higher in inpatients (IPs) than outpatients (OPs), with peak occurrences in autumn and winter among IPs and in spring among OPs. Age and sex significantly influenced pathogen isolation rates. The multiple antibiotic resistance (MAR) index was highest for S. aureus isolates between 2017 and 2019, which showed complete resistance to vancomycin and oxacillin. Key resistance genes mecA, vanA, tetM, and aph(3') were frequently co-detected in S. aureus. Polymyxin B and colistin remained the most effective antibiotics against multidrug-resistant (MDR) strains. Conclusion These findings highlight the critical need for year-round AMR surveillance, with an enhanced focus during seasonal peaks, particularly for high-risk IPs in winter and autumn. Implementing localized antimicrobial stewardship programs (ASPs) and robust infection control measures is essential to reduce the AMR burden and curb its spread in inpatient settings, especially in resource-constrained healthcare systems, such as Pakistan.https://doi.org/10.1186/s12879-025-11171-3Antimicrobial resistanceESKAPE pathogensHospital-acquired infectionsCardiac patientsInpatientsAnd outpatients |
| spellingShingle | Muhammad Umer Asghar Arsalan Haseeb Zaidi Muhammad Tariq Noor Ul Ain Seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients: insights from a 7-Year study BMC Infectious Diseases Antimicrobial resistance ESKAPE pathogens Hospital-acquired infections Cardiac patients Inpatients And outpatients |
| title | Seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients: insights from a 7-Year study |
| title_full | Seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients: insights from a 7-Year study |
| title_fullStr | Seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients: insights from a 7-Year study |
| title_full_unstemmed | Seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients: insights from a 7-Year study |
| title_short | Seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients: insights from a 7-Year study |
| title_sort | seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients insights from a 7 year study |
| topic | Antimicrobial resistance ESKAPE pathogens Hospital-acquired infections Cardiac patients Inpatients And outpatients |
| url | https://doi.org/10.1186/s12879-025-11171-3 |
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