Ghenea Alice Elena, Cioboată Ramona, Drocaş Andrei Ioan, Țieranu Eugen Nicolae, Vasile Corina Maria, Moroşanu Aritina, Țieranu Cristian George, Salan Alex-Ioan, Popescu Mihaela, Turculeanu Adriana, Padureanu Vlad, Udriștoiu Anca-Loredana, Calina Daniela, Cȃrţu Dan, Zlatian Ovidiu Mircea
Department of Bacteriology-Virology-Parasitology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Department of Pneumology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Antibiotics (Basel). 2021 Jul 16;10(7):868. doi: 10.3390/antibiotics10070868.
The study evaluated the evolution of the incidence of infections with in the County Clinical Emergency Hospital of Craiova (SCJUC), Romania. Also, we monitored antibiotic resistance over more than two years and detected changes in resistance to various antimicrobial agents. Our study included 2062 patients (823 women and 1239 men) hospitalised in SCJUC during the period 1st of September 2017 to 30 June 2019. In 458 patients (22.21%) from the 2062 total patients, the collected samples (1116) were positive and from those, we isolated 251 strains of spp. We conducted a longitudinal analysis of the prevalence of spp. over calendar months, which showed a prevalence in surgical wards that ranged between 5.25% and 19.49% in June 2018, while in medical wards the variation was much wider, between 5.15% and 17.36% in April 2018. spp. strains showed significant resistance to Amoxicillin/Clavulanate, Aztreonam and Cephalosporins such as Ceftriaxone, Ceftazidime and Cefepime. We examined the possible link with the consumption of antibiotics in the same month by performing a multiple linear regression analysis. The evolution of antibiotic resistance in was correlated with the variation of resistance in other bacteria, which suggests common resistance mechanisms in the hospital environment. By performing the regression for dependency between antibiotic resistance and antibiotic consumption, we observed some correlations between antibiotic consumption and the development of antibiotic resistance after 1, 2 and even 3 months (e.g., resistance to meropenem was influenced by the consumption in the hospital ward of imipenem 1 month and two months before, but only 1 month before by the consumption of meropenem). The clustering of strains showed filiation between multiresistant spp. strains isolated from specific patients from the ICU. The evolution of prevalence and antibiotic resistance in correlated with the resistance in other bacteria, which suggest common resistance mechanisms in the hospital environment, and also with the consumption of antibiotics.
该研究评估了罗马尼亚克拉约瓦县临床急诊医院（SCJUC）感染的发病率变化情况。此外，我们监测了两年多时间里的抗生素耐药性，并检测了对各种抗菌药物耐药性的变化。我们的研究纳入了2017年9月1日至2019年6月30日期间在SCJUC住院的2062名患者（823名女性和1239名男性）。在2062名患者中的458名患者（22.21%）中，所采集的样本（1116份）呈阳性，从中我们分离出251株[具体菌种名称]菌株。我们对[具体菌种名称]菌株在各个日历月的流行情况进行了纵向分析，结果显示外科病房的流行率在2018年6月介于5.25%至19.49%之间，而内科病房的变化幅度更大，在2018年4月介于5.15%至17.36%之间。[具体菌种名称]菌株对阿莫西林/克拉维酸、氨曲南以及头孢菌素类药物如头孢曲松、头孢他啶和头孢吡肟表现出显著耐药性。我们通过进行多元线性回归分析研究了与当月抗生素使用量之间的可能联系。[具体菌种名称]抗生素耐药性的演变与其他细菌耐药性的变化相关，这表明医院环境中存在共同的耐药机制。通过对抗生素耐药性与抗生素使用量之间的依存关系进行回归分析后，我们观察到抗生素使用量与1个月、2个月甚至3个月后的抗生素耐药性发展之间存在一些相关性（例如，美罗培南的耐药性受到1个月和2个月前医院病房亚胺培南使用量的影响，但仅受1个月前美罗培南使用量的影响）。菌株聚类显示从重症监护病房特定患者分离出的多重耐药[具体菌种名称]菌株之间存在亲缘关系。[具体菌种名称]流行率和抗生素耐药性的演变与其他细菌的耐药性相关，这表明医院环境中存在共同的耐药机制，同时也与抗生素的使用量相关。
