Antibiotics (Basel, Switzerland) · 2025
Antimicrobial Resistance in ESKAPE Pathogens: A Retrospective Epidemiological Study at the University Hospital of Palermo, Italy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Pipitò Luca, Rubino Raffaella, D'Agati Giulio, Bono Eleonora, Mazzola Chiara Vincenza, Urso Sofia, Zinna Giuseppe, Distefano Salvatore Antonino, Firenze Alberto, Bonura Celestino, Giammanco Giovanni M, Cascio Antonio
Аннотация
BACKGROUND: Antimicrobial resistance (AMR) is an escalating global health threat, projected to cause over 40 million deaths by 2050. ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) are major contributors to nosocomial infections and AMR. We evaluated the epidemiology and AMR prevalence of ESKAPE pathogens at the University Hospital in Palermo between January 2018 and July 2023, analyzing factors associated with mortality in patients with positive blood cultures.
METHODS: Microbiological data from all specimen types were collected using the Business Intelligence system Biwer, excluding duplicates. We assessed the prevalence and trends of ESKAPE isolates and AMR over time. Clinical data from hospital discharge forms were used to evaluate factors associated with mortality in patients with ESKAPE-positive blood cultures. Differences in AMR prevalence between blood and non-blood isolates were examined.
RESULTS: A total of 11,607 specimens from 4916 patients were analyzed. Most patients were admitted to Internal Medicine (19.4%), the ICU (13.2%), and General Surgery (9.9%). Additionally, 21.5% of the specimens were collected from ICU-admitted patients. Blood cultures accounted for 14.3% of the specimens, urine for 25.3%, respiratory secretions for 22.1%, and skin and mucosal swabs for 20.9%. The prevalence of all isolates increased progressively, peaking in 2021. The vancomycin-resistant E. faecium prevalence was 19.4%, with a significant upward trend, while oxacillin-resistant S. aureus prevalence was 35.0%, showing a significant decline. A. baumannii exhibited high resistance to all antibiotics tested except for colistin and cefiderocol. Carbapenemase resistance was 55.0% in K. pneumoniae, 20.4% in P. aeruginosa, and 4.6% in Enterobacter spp. P. aeruginosa showed a significant decrease in meropenem resistance. K. pneumoniae and A. baumannii bloodstream infections were linked to higher mortality risk.
METHODS: Microbiological data from all specimen types were collected using the Business Intelligence system Biwer, excluding duplicates. We assessed the prevalence and trends of ESKAPE isolates and AMR over time. Clinical data from hospital discharge forms were used to evaluate factors associated with mortality in patients with ESKAPE-positive blood cultures. Differences in AMR prevalence between blood and non-blood isolates were examined.
RESULTS: A total of 11,607 specimens from 4916 patients were analyzed. Most patients were admitted to Internal Medicine (19.4%), the ICU (13.2%), and General Surgery (9.9%). Additionally, 21.5% of the specimens were collected from ICU-admitted patients. Blood cultures accounted for 14.3% of the specimens, urine for 25.3%, respiratory secretions for 22.1%, and skin and mucosal swabs for 20.9%. The prevalence of all isolates increased progressively, peaking in 2021. The vancomycin-resistant E. faecium prevalence was 19.4%, with a significant upward trend, while oxacillin-resistant S. aureus prevalence was 35.0%, showing a significant decline. A. baumannii exhibited high resistance to all antibiotics tested except for colistin and cefiderocol. Carbapenemase resistance was 55.0% in K. pneumoniae, 20.4% in P. aeruginosa, and 4.6% in Enterobacter spp. P. aeruginosa showed a significant decrease in meropenem resistance. K. pneumoniae and A. baumannii bloodstream infections were linked to higher mortality risk.