Evolution of Antimicrobial Resistance in <i>Klebsiella pneumoniae</i> over 3 Years (2019-2021) in a Tertiary Hospital in Bucharest, Romania

• Главные авторы: Alexandra Cireșă (Автор), Daniela Tălăpan (Автор), Carmen-Cristina Vasile (Автор), Cristina Popescu (Автор), Gabriel-Adrian Popescu (Автор)
• Формат: ‌
• Опубликовано: MDPI AG, 2024-05-01T00:00:00Z.
• Предметы: article
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Итог

Background: The antimicrobial resistance (AMR) of <i>Klebsiella pneumoniae</i> recorded a steep upward trend over the last two decades, among which carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) is one of the most concerning strains considering the development and spread of AMR. The aim of this study was to analyze the evolution of AMR for <i>Klebsiella pneumoniae</i> and to describe the risk factors of AMR for <i>Klebsiella pneumoniae</i>, including the COVID-19 pandemic. Methods: We conducted a retrospective study on <i>Klebsiella pneumoniae</i> non-duplicative isolates collected from patients admitted to a tertiary hospital in Bucharest, Romania, from January 2019 to December 2021. We evaluated AMR changes by comparing resistance between 2019 and the mean of 2020-2021. Results: The rates of AMR increased for third-generation cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and colistin and decreased for trimethoprim/sulfamethoxazole (TMP/SMX), 45.7% in 2019 vs. 28.3% in 2021. A longer length of hospital stay (ꭓ² = 49.68, <i>p</i> < 0.01); recent antibiotic consumption, RR = 1.38, 95% CI [1.21, 1.57]; and recent contact with hospital settings, RR = 1.54, 95% CI [1.32, 1.8] were risk factors for multidrug-resistant (MDR) <i>Klebsiella pneumoniae</i>. Conclusions: The AMR of <i>Klebsiella pneumoniae</i> increased during 2020-2021 for most of the potential active antibiotics; only TMP/SMX resistance decreased, and it may represent a treatment option for CRKP or MDR <i>Klebsiella pneumoniae</i> infections. Decreasing the excessive use of antibiotics and the implementation of prevention and control measures in healthcare settings are mandatory for avoiding further increases in the AMR rate of <i>Klebsiella pneumoniae</i>.

Примечание

10.3390/antibiotics13050431
2079-6382