Enterobacteria in the hospital environment and their antimicrobial resistance

Abstract

Background: Enterobacteria can produce enzymes (ESBLs) to inactivate beta-lactamins and can also be resistant to carbapenems (CRE), as superbugs. Objective: To evaluate the superbacteria frequency in the last two years in Arad County Clinical Hospital. Material and methods: The multidrug criteria described in Clinical Microbiology and Infection Volume 18, Issue 3, 2011 were used. VITEK and E-test for ESBLs and diffusometric anti-biograms methods for CRE were used, interpreted according to EUCAST and CLSI. Results: Were identified 5093 isolates, 67.85% were Gram negative (n = 3456), 2905 were enterobacteria (57.03% of total, 84.05% of Gram negatives). ESBLs represent 19.53% (n = 995), 15.2% (n = 151) in Surgical wards, 14.94% (n = 149) on ICU and 12.8% (n = 127) in Internal Medicine departments; they were present in all 24 hospital wards, colonizing even ambulatory patients (n = 32; 3.2%). Superbugs were 117 of these, most of which were present on ICUs (n = 57; 48.7%), Neurology (n = 15; 12.8%), Surgery (n=15; 12.8%) and Palliative (n = 12; 10.3%). Most multidrug resistant organisms were Klebsiella pneumoniae (n = 58; 49.6%), Proteus spp (n = 28; 23.91%) and Providencia stuartti (n = 19; 16.2%). Conclusions: Enterobacteria with extended resistance to cephalosporins and carbapenems were identified in the last two years in this hospital, especially in the ICU, Surgical and Internal Medicine departments, colonizing ambulatory patients as well. They are in the WHO alert, along with other Gram negative species, as Acinetobacter baumannii and Pseudomonas aeruginosa.