Temporal trends and patterns in antimicrobial-resistant Gram-negative bacteria implicated in intensive care unit-acquired infections: A cohort-based surveillance study in Istanbul, Turkey

•Surveillance of Gram-negative bacterial infections in intensive care patients in Istanbul.•Overall infection rate substantially and progressively decreased over 4 years.•Antimicrobial resistance patterns varied markedly by organism and time.•A back-to-susceptibility trend was noted for Pseudomonas...

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Bibliographic Details
Published in:Journal of global antimicrobial resistance. 2018-09, Vol.14, p.190-196
Main Authors: Durdu, Bulent, Kritsotakis, Evangelos I., Lee, Andrew C.K., Torun, Perihan, Hakyemez, Ismail N., Gultepe, Bilge, Aslan, Turan
Format: Article
Language:English
Subjects:
Antimicrobial resistance
Gram-negative bacteria
Intensive care unit
Nosocomial infection
Surveillance
Time trends
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Summary:•Surveillance of Gram-negative bacterial infections in intensive care patients in Istanbul.•Overall infection rate substantially and progressively decreased over 4 years.•Antimicrobial resistance patterns varied markedly by organism and time.•A back-to-susceptibility trend was noted for Pseudomonas aeruginosa.•Extensively drug-resistant proportions remained constant in Klebsiella spp. but increased in Acinetobacter baumannii. This study assessed trends and patterns in antimicrobial-resistant intensive care unit (ICU)-acquired infections caused by Gram-negative bacteria (GNB) in Istanbul, Turkey. Bacterial culture and antimicrobial susceptibility data were collected for all GNB causing nosocomial infections in five adult ICUs of a large university hospital in 2012–2015. Multiresistance patterns were categorised as multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR). Temporal patterns and trends were assessed using regression analyses. Of 991 pathogenic GNB recorded, the most frequent were Acinetobacter baumannii (35.3%), Klebsiella spp. (26.7%), Pseudomonas aeruginosa (18.1%) and Escherichia coli (6.7%). The overall infection rate decreased by 41% from 18.4 to 10.9 cases per 1000 patient-days in 2012 compared with 2015 (P
ISSN:2213-7165
2213-7173
DOI:10.1016/j.jgar.2018.04.015