Subject: Multidrug resistance
Subject: Infection control
Subject: Stewardship
Subject: Low- and upper-middle and high income
Subject: XDR
Subject: Pan-drug resistance
Year: 2021
Type: Article
Title: Profiles of multidrug-resistant organisms among patients with bacteremia in intensive care units: an international ID-IRI survey
Author: El-Sokkary, Rehab
Author: Uysal, Serhat
Author: Erdem, Hakan
Author: Kullar, Ravina
Author: Pekok, Abdullah Umut
Author: Amer, Fatma
Author: Grgić, Svjetlana
Author: Carevic, Biljana
Author: El-Kholy, Amani
Author: Liskova, Anna
Author: Özdemir, Mehmet
Author: Khan, Ejaz Ahmed
Author: Uygun-Kizmaz, Yesim
Author: Pandak, Nenad
Author: Pandya, Nirav
Author: Arapović, Jurica
Author: Karaali, Rıdvan
Author: Oztoprak, Nefise
Author: Petrov, Michael M
Author: Alabadla, Rami
Author: Alay, Handan
Author: Kholy, Jehan Ali El
Author: Landelle, Caroline
Author: Khedr, Reham
Author: Mamtora, Dhruv
Author: Dragovac, Gorana
Author: Fernandez, Ricardo
Author: Evren, Emine Unal
Author: Raka, Lul
Author: Cascio, Antonio
Author: Dauby, Nicolas
Author: Oncul, Ahsen
Author: Balin, Safak Ozer
Author: Cag, Yasemin
Author: Dirani, Natalia
Author: Dogan, Mustafa
Author: Dumitru, Irina Magdalena
Author: Gad, Maha Ali
Author: Darazam, Ilad Alavi
Author: Naghili, Behrouz
Author: Del Vecchio, Rosa Fontana
Author: Licker, Monica
Author: Marino, Andrea
Author: Akhtar, Nasim
Author: Kamal, Mostafa
Author: Angioni, Goffredo
Author: Medić, Deana
Author: Esmaoğlu, Aliye
Author: Gergely, Szabo Balint
Author: Silva-Pinto, André
Author: Santos, Lurdes
Author: Miftode, Ionela Larisa
Author: Tekin, Recep
Author: Wongsurakiat, Phunsup
Author: Khan, Mumtaz Ali
Author: Kurekci, Yesim
Author: Pilli, Hema Prakash
Author: Grozdanovski, Krsto
Author: Miftode, Egidia
Author: Baljic, Rusmir
Author: Vahabolgu, Haluk
Author: Rello, Jordi
Abstract: Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile of multidrug-resistant organisms (MDROs) among hospitalized patients with bacteremia in intensive care units (ICUs) in a large geographical area. This is a 1-month cross-sectional survey for blood-borne pathogens in 57 ICUs from 24 countries with different income levels: lower-middle-income (LMI), upper-middle-income (UMI), and high-income (HI) countries. Multidrug-resistant (MDR), extensively drug-resistant (XDR), or pan-drug-resistant isolates were searched. Logistic regression analysis determined resistance predictors among MDROs. Community-acquired infections were comparable to hospital-acquired infections particularly in LMI (94/202; 46.5% vs 108/202; 53.5%). Although MDR (65.1%; 502/771) and XDR (4.9%; 38/771) were common, no pan-drug-resistant isolate was recovered. In total, 32.1% of MDR were Klebsiella pneumoniae, and 55.3% of XDR were Acinetobacter baumannii. The highest MDR and XDR rates were in UMI and LMI, respectively, with no XDR revealed from HI. Predictors of MDR acquisition were male gender (OR, 12.11; 95% CI, 3.025-15.585) and the hospital-acquired origin of bacteremia (OR, 2.643; 95%CI, 1.462-3.894), and XDR acquisition was due to bacteremia in UMI (OR, 3.344; 95%CI, 1.189-5.626) and admission to medical-surgical ICUs (OR, 1.481; 95% CI, 1.076-2.037). We confirm the urgent need to expand stewardship activities to community settings especially in LMI, with more paid attention to the drugs with a higher potential for resistance. Empowering microbiology laboratories and reports to direct prescribing decisions should be prioritized. Supporting stewardship in ICUs, the mixed medical-surgical ones in particular, is warranted.
Publisher: Springer Science and Business Media LLC
Relation: European Journal of Clinical Microbiology & Infectious Diseases
Identifier: oai:repository.ukim.mk:20.500.12188/29716
Identifier: http://hdl.handle.net/20.500.12188/29716Identifier: 10.1007/s10096-021-04288-1
Identifier: https://link.springer.com/content/pdf/10.1007/s10096-021-04288-1.pdf
