Dados do Trabalho

Título

A 6-Year Retrospective Study of The Profile of Antimicrobial Resistance of Klebsiella pneumoniae in a Public Hospital in Mossoró/RN

Introdução

Klebsiella pneumoniae is a Gram-negative, encapsulated bacterium that plays a significant role in nosocomial infections, including pneumonia, sepsis, urinary tract infections, and surgical wound infections, particularly in immunocompromised patients. The acquisition of antimicrobial resistance mechanisms is a growing public health concern, complicating the treatment of infections caused by this pathogen. Therefore, epidemiological surveillance of the antibiotic resistance profile of K. pneumoniae is crucial for effective infection management. 

Objetivo (s)

This study aims to evaluate the antibiotic resistance profile of K. pneumoniae isolates from clinical samples of patients hospitalized in the largest public hospital in Mossoró, RN. 

Material e Métodos

This observational, quantitative, longitudinal, and retrospective study was conducted at Tarcísio Maia Regional Hospital between 2017 and 2022, with approval from the Research Ethics Committee (approval number 4.708.190). Data were collected from microbiology laboratory records and/or the hospital's infection control committee for cultures positive for K. pneumoniae during the specified period. The collected data included the type of clinical sample, date of collection, patient ward, and antimicrobial resistance profile (considering only antibiotics tested in more than 50% of K. pneumoniae cultures).

Resultados e Conclusão

A total of 398 isolates were identified during the study period, predominantly from intensive care units (51%). Most isolates originated from tracheal secretions (29%), followed by urine (28%). Most isolates were resistant to cephalothin (90%), amoxicillin/clavulanate (75%), and ceftriaxone (77%), while they were susceptible to amikacin (84%), gentamicin (64%), and meropenem (65%). Between 2018 and 2021, there was an increase in resistance to all antibiotics, whereas from 2021 to 2022, there was a decrease in resistance rates for all antibiotics, most notably a ≅38% reduction for meropenem. A significant number of multidrug-resistant K. pneumoniae strains were identified in the hospital during the study period, particularly during the COVID-19 pandemic. Notably, even the most effective antimicrobials faced considerable resistance from the bacterium. Additionally, there are concerning differences in the number of isolates from different hospital sectors and collection sites, indicating potential risk factors.

Palavras Chave

Klebsiella pneumoniae; Antimicrobial Drug Resistance; infection