Ioannou Petros, Maraki Sofia, Koumaki Dimitra, Manios Georgios A, Koumaki Vasiliki, Kassotakis Dimitrios, Zacharopoulos Georgios V, Kofteridis Diamantis P, Manios Andreas, de Bree Eelco
School of Medicine, University of Crete, 71003 Heraklion, Greece.
Internal Medicine Department, University Hospital of Heraklion, 71110 Heraklion, Greece.
Antibiotics (Basel). 2023 Mar 1;12(3):490. doi: 10.3390/antibiotics12030490.
Surgery has revolutionized the practice of medicine by allowing the treatment of conditions amenable to conservative medical management with some of them pathophysiologically involving the prevalence of pathogenic microorganisms. On the other hand, infections such as surgical site infections or urinary tract infections may complicate patients hospitalized in surgical wards leading to considerable morbidity, mortality, and increased healthcare-associated costs. The aim of this study was to present the microbiological characteristics and antimicrobial resistance of all isolates identified in microbiological specimens from a surgical ward of a tertiary hospital in Greece during a six-year period. Only specimens that yielded at least one microorganism were included in the analysis. In total, 1459 strains in 789 positive cultures were isolated. The most common sample sent to the microbiology department was pus from surgical wounds. The most common pathogens among all 1459 strains isolated were Enterobacterales at 33% ( = 482), however, the most common genus was at 22.3% ( = 326). Antimicrobial resistance against third-generation cephalosporins was 23% ( = 111/482) among Enterobacterales, while, the rate of vancomycin-resistant enterococci (VRE) was 18.5% ( = 60/324) among species and was increasing in the last years of the study. Antimicrobial resistance of to carbapenems was 68.8% ( = 11/16), which was lower than the corresponding rate in other wards in Greece. The antimicrobial resistance rates noted herein raise questions regarding the appropriateness of currently suggested antimicrobials in guidelines and imply that a revision could be required. Practicing clinicians should always be aware of local microbiological data that allow the selection of appropriate antimicrobials for the management of infections. Finally, the increasing rates of VRE noted herein mandate further actions from the point of infection control and antimicrobial stewardship.
外科手术通过对一些病理生理上涉及致病微生物流行的、适合保守药物治疗的病症进行治疗,彻底改变了医学实践。另一方面,诸如手术部位感染或尿路感染等感染可能会使入住外科病房的患者病情复杂化,导致相当高的发病率、死亡率以及医疗相关成本的增加。本研究的目的是呈现希腊一家三级医院外科病房在六年期间微生物标本中鉴定出的所有分离株的微生物学特征和抗菌药物耐药性。分析仅纳入了产生至少一种微生物的标本。总共从789份阳性培养物中分离出1459株菌株。送往微生物学部门的最常见样本是手术伤口的脓液。在分离出的所有1459株菌株中,最常见的病原体是肠杆菌目,占33%(n = 482),然而,最常见的属是肠球菌属,占22.3%(n = 326)。肠杆菌目中对第三代头孢菌素的耐药率为23%(n = 111/482),而在肠球菌属中耐万古霉素肠球菌(VRE)的比例为18.5%(n = 60/324),且在研究的最后几年呈上升趋势。肠球菌属对碳青霉烯类的耐药率为68.8%(n = 11/16),低于希腊其他病房的相应比例。本文所指出的抗菌药物耐药率引发了关于当前指南中建议的抗菌药物是否恰当的问题,并暗示可能需要进行修订。临床医生应始终了解当地的微生物学数据,以便选择合适的抗菌药物来治疗感染。最后,本文所指出的VRE比例上升要求在感染控制和抗菌药物管理方面采取进一步行动。