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Measurement and prediction of antimicrobial resistance in bloodstream infections by ESKAPE pathogens and Escherichia coli.
De Socio, Giuseppe Vittorio; Rubbioni, Paola; Botta, Daniele; Cenci, Elio; Belati, Alessandra; Paggi, Riccardo; Pasticci, Maria Bruna; Mencacci, Antonella.
Afiliação
  • De Socio GV; Unit of Infectious Diseases, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy. Electronic address: giuseppe.desocio@ospedale.perugia.it.
  • Rubbioni P; Department of Mathematics and Computer Science, University of Perugia, Perugia, Italy.
  • Botta D; Unit of Infectious Diseases, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
  • Cenci E; Medical Microbiology, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
  • Belati A; Medical Microbiology, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
  • Paggi R; Medical Microbiology, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
  • Pasticci MB; Unit of Infectious Diseases, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
  • Mencacci A; Medical Microbiology, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
J Glob Antimicrob Resist ; 19: 154-160, 2019 12.
Article em En | MEDLINE | ID: mdl-31112804
ABSTRACT

OBJECTIVES:

This study aimed to evaluate a cumulative antimicrobial resistance index (ARI) as a possible key outcome measure of antimicrobial stewardship programmes (ASPs) and a tool to predict the antimicrobial resistance (AMR) trend.

METHODS:

Antimicrobial susceptibility for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli (ESKAPEEc) pathogens recovered from blood cultures during a 5-year period (2014-2018) was analysed to obtain a cumulative ARI. For each antibiotic tested, a score of 0, 0.5 or 1 was assigned for susceptibility, intermediate resistance or resistance, respectively, and the ARI was calculated by dividing the sum of these scores by the number of antibiotics tested. Cumulative ARIs of ESKAPEEc micro-organisms were compared and a mathematical prediction model for AMR trend was obtained.

RESULTS:

In total, 1858 ESKAPEEc isolates were included in the study. The cumulative ESKAPEEc mean ARI increased significantly from 0.200 ± 0.01 in 2014 to 0.276 ± 0.02 in 2018 (P < 0.001). In multivariable regression analysis, factors significantly associated with ARI ≥ 0.5 were E. faecium, K. pneumoniae, P. aeruginosa and A. baumannii infection (P < 0.001) and infection occurring after 2014 (P < 0.05). Based on the prediction model obtained, in the absence of any interventional measure, a tendency to pandrug resistance of the ESKAPEEc group could be expected in the next 8-15 years.

CONCLUSION:

The ARI could be a useful tool to measure the impact of ASPs on AMR. The increasing incidence of AMR among ESKAPEEc organisms underscores the needing for ASPs.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Bactérias / Bacteriemia / Farmacorresistência Bacteriana / Antibacterianos Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Bactérias / Bacteriemia / Farmacorresistência Bacteriana / Antibacterianos Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article