Surveillance of multi-drug resistant pathogens in two Romanian university hospitals

Monica Licker, Luminita Baditoiu, Delia Muntean, Liliana Dragomirescu, Florin Horhat, Ciprian Piluţ, Elena Hogea, Petru Deutsch, Angela Adam, Roxana Moldovan

Abstract


Hospital acquired infections and bacterial multi-drug resistance (MDR) involve high costs, difficult to manage in medical systems with limited resources. This study, part of the PNCDII 42121/2008 national research project, proposed the investigation of multidrug-resistant bacteria prevalence, concurrent with costs evaluation in two intensive care units (ICUs) from Timisoara university hospitals: Emergency Clinical County Hospital (ECCH) and Institute of Cardiovascular Diseases (ICD). During January-October 2010, we performed a surveillance focused on the following major exponents: Meticillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta-lactamase (ESBL) producing enterobacteria and carbapenem-resistant non-fermentative Gram negative bacilli, with duplicates and colonisation germs exclusion. Selected germs identification and phenotyping were performed with the help of automatic VITEK 2 compact system, using VITEK 2 GP/GN identification cards and AST cards for antimicrobial sensitivity tests. We also performed Hodge tests for ESBL producing carbapenem resistant enterobacteria. At ECCH we isolated 534 bacterial strains, with a 35,44% prevalence for MRSA, 37,32% ESBL enterobacteria and 43,94% carbapenem-resistant nonfermenters. From 73 strains isolated from ICD, the MRSA prevalence was 8,00%, respectively 23,33% ESBL enterobacteria and 11,11% carbapenem-resistant non-fermentatives. The average number of antimicrobial treatment days/MDR infectious episode was 9.11days in ECCH/29.57days in ICD, with an average hospitalisation cost of 3,657.35 €/patient in ECCH/3,780.87 €/patient in ICD. As a conclusion, the study established high prevalence rates of Gram negative bacteria, especially of carbapenem-resistant nonfermenters and evaluated the burden produced on our sanitary sistem, by infections with MDR bacteria.

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DOI: http://dx.doi.org/10.3396/ijic.v8i4.10363