Multidrug-resistant bacteria in surgical intensive care units
Background and aim: The most important multidrug-resistant (MDR) bacteria are extended-spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), Pseudomonas aeruginosa (CRPE), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resista...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524001942 |
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| author | Daniela Bandić Pavlović Mladen Pospišil Marina Nađ Haris Car Vilena Vrbanović Mijatović Dinko Tonković Jasmina Vraneš Nataša Beader Robert Baronica Branka Bedenić |
| author_facet | Daniela Bandić Pavlović Mladen Pospišil Marina Nađ Haris Car Vilena Vrbanović Mijatović Dinko Tonković Jasmina Vraneš Nataša Beader Robert Baronica Branka Bedenić |
| author_sort | Daniela Bandić Pavlović |
| collection | DOAJ |
| description | Background and aim: The most important multidrug-resistant (MDR) bacteria are extended-spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), Pseudomonas aeruginosa (CRPE), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus spp (VRE). We evaluated the MDR bacteria in surgical ICUs in the tertiary hospital in Croatia. MATERIAL AND METHODS: The antibiotic susceptibility testing was performed by disk-diffusion and broth dilution method. Double disk synergy test and inhibitor based test with clavulanic acid were applied to screen for ESBLs. Transferability of resistance traits was determined by conjugation. The nature of ESBL, carbapenemases, and fluoroquinolone resistance determinants was investigated by PCR. RESULTS: 119 MDR isolates were analysed: 41 Klebsiella pneumoniae, 38 Acinetobacter bambini, five Pseudomonas aeruginosa, four Proteus. mirabilis, three Escherichia coli, two Enterobacter cloacae, and thirteen MRSA and VRE, respectively.Phenotypic tests were positive in 37 K. pneumoniae and all E. cloacae and E. coli isolates indicating production of an ESBL. Hodge test and CIM were positive in all but one strain, consistent with the carbapenemase production. Ertapenem resistance was transferable from 12 isolates positive for OXA-48 carbapenemase. PCR detected OXA-48 carbapenemase carried by IncL plasmid, in 34 K. pneumoniae, and one E. cloacae and E. coli isolate respectively, and NDM in three K. pneumoniae isolates. OXA-48 positive isolates coharboured ESBLs belonging to CTX-M family. All A. baumannii isolates tested positive for OXA-23 carbapenemase, whereas four P. aeruginosa produced VIM-2. CONCLUSIONS: OXA-48 was the dominant resistance trait among K. pneumoniae isolates, while OXA-23 was the only carbapenemase among A. baumannii isolates. |
| format | Article |
| id | doaj-art-e9a52d4e428040688847a4bf6c54ef5d |
| institution | DOAJ |
| issn | 2213-7165 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj-art-e9a52d4e428040688847a4bf6c54ef5d2025-08-20T02:50:47ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-0139610.1016/j.jgar.2024.10.017Multidrug-resistant bacteria in surgical intensive care unitsDaniela Bandić Pavlović0Mladen Pospišil1Marina Nađ2Haris Car3Vilena Vrbanović Mijatović4Dinko Tonković5Jasmina Vraneš6Nataša Beader7Robert Baronica8Branka Bedenić9University of Zagreb School of MedicineUniversity Hospital Centre ZagrebUniversity of Zagreb School of MedicineZagreb Health SchoolUniversity of Zagreb School of MedicineUniversity of Zagreb School of MedicineAndrija Štampar Teaching Public Health InstituteUniversity of Zagreb School of MedicineUniversity Hospital Centre ZagrebUniversity of Zagreb School of MedicineBackground and aim: The most important multidrug-resistant (MDR) bacteria are extended-spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), Pseudomonas aeruginosa (CRPE), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus spp (VRE). We evaluated the MDR bacteria in surgical ICUs in the tertiary hospital in Croatia. MATERIAL AND METHODS: The antibiotic susceptibility testing was performed by disk-diffusion and broth dilution method. Double disk synergy test and inhibitor based test with clavulanic acid were applied to screen for ESBLs. Transferability of resistance traits was determined by conjugation. The nature of ESBL, carbapenemases, and fluoroquinolone resistance determinants was investigated by PCR. RESULTS: 119 MDR isolates were analysed: 41 Klebsiella pneumoniae, 38 Acinetobacter bambini, five Pseudomonas aeruginosa, four Proteus. mirabilis, three Escherichia coli, two Enterobacter cloacae, and thirteen MRSA and VRE, respectively.Phenotypic tests were positive in 37 K. pneumoniae and all E. cloacae and E. coli isolates indicating production of an ESBL. Hodge test and CIM were positive in all but one strain, consistent with the carbapenemase production. Ertapenem resistance was transferable from 12 isolates positive for OXA-48 carbapenemase. PCR detected OXA-48 carbapenemase carried by IncL plasmid, in 34 K. pneumoniae, and one E. cloacae and E. coli isolate respectively, and NDM in three K. pneumoniae isolates. OXA-48 positive isolates coharboured ESBLs belonging to CTX-M family. All A. baumannii isolates tested positive for OXA-23 carbapenemase, whereas four P. aeruginosa produced VIM-2. CONCLUSIONS: OXA-48 was the dominant resistance trait among K. pneumoniae isolates, while OXA-23 was the only carbapenemase among A. baumannii isolates.http://www.sciencedirect.com/science/article/pii/S2213716524001942Klebsiella pneumoniaeAcinetobacter baumanniiPseudomonas aeruginosasurgical intensive care unitmultidrug-resistant bacteria |
| spellingShingle | Daniela Bandić Pavlović Mladen Pospišil Marina Nađ Haris Car Vilena Vrbanović Mijatović Dinko Tonković Jasmina Vraneš Nataša Beader Robert Baronica Branka Bedenić Multidrug-resistant bacteria in surgical intensive care units Journal of Global Antimicrobial Resistance Klebsiella pneumoniae Acinetobacter baumannii Pseudomonas aeruginosa surgical intensive care unit multidrug-resistant bacteria |
| title | Multidrug-resistant bacteria in surgical intensive care units |
| title_full | Multidrug-resistant bacteria in surgical intensive care units |
| title_fullStr | Multidrug-resistant bacteria in surgical intensive care units |
| title_full_unstemmed | Multidrug-resistant bacteria in surgical intensive care units |
| title_short | Multidrug-resistant bacteria in surgical intensive care units |
| title_sort | multidrug resistant bacteria in surgical intensive care units |
| topic | Klebsiella pneumoniae Acinetobacter baumannii Pseudomonas aeruginosa surgical intensive care unit multidrug-resistant bacteria |
| url | http://www.sciencedirect.com/science/article/pii/S2213716524001942 |
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