Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 2;13(4):296-308.
doi: 10.1055/s-0041-1730819. eCollection 2021 Dec.

Antimicrobial Resistance in Enterobacteriaceae Bacteria Causing Infection in Trauma Patients: A 5-Year Experience from a Tertiary Trauma Center

Omika Katoch  1 , Surbhi Khurana  1 , Purva Mathur  1 , Rajesh Malhotra  2
Affiliations

Antimicrobial Resistance in Enterobacteriaceae Bacteria Causing Infection in Trauma Patients: A 5-Year Experience from a Tertiary Trauma Center

Omika Katoch et al. J Lab Physicians. .

Abstract

Introduction Multiple drug resistance emergences among bacteria at an alarming rate worldwide are posing a serious threat to the treatment benefits that have been achieved with antibiotics. This crisis is due to the inappropriate and overuse of existing antibiotics. We evaluated the antimicrobial resistance pattern of Enterobacteriaceae pathogens isolated from intensive care units (ICUs), wards, and outpatient department (OPD) patients. Objectives The aim of the study is to determine the antimicrobial resistance pattern in bacteria of Enterobacteriaceae family. Material and Methods This is a retrospective study conducted at a tertiary care level-1 trauma center in the capital city of India. We collected all the retrospective data of 5 years from the laboratory information system software of the microbiology laboratory. The retrospective data included patients' details, samples detail, organism's identification, and their antimicrobial susceptibility testing, done by Vitek2 compact system and disk diffusion test according to each year's Clinical and Laboratory Standards Institute (CLSI) guidelines. This study included the interpretation of zone diameters and minimum inhibitory concentrations of all isolates according to CLSI guidelines, 2018. Results Among all the Enterobacteriaceae , Klebsiella spp. was the most commonly isolated pathogen, followed by Escherichia coli and Enterobacter spp. in ICUs and wards, while in OPD patients E. coli was the most commonly isolated pathogen, followed by Klebsiella spp. and Enterobacter spp. Enterobacteriaceae isolates remained resistant to all classes of cephalosporins in all settings. In addition, β lactam and β-lactamase inhibitor remained less effective. Carbapenems showed less resistance than quinolones and aminoglycosides. Among the different antimicrobial agents, tigecycline proved most effective in all settings; however, it showed more resistance than other studies. Conclusion Tigecycline proved effective among different multidrug resistance bacteria. Multidrug resistance in bacteria leads to prolonged hospital stays as well as makes the treatment less cost effective. Proper and judicious use of antimicrobials is the need of the hour.

Keywords: Enterobacteriaceae; Escherichia coli; Klebsiella spp.; Vitek2; antibiotic resistance; disk diffusion; tigecycline.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None declared. Ethical Approval Since this is a retrospective study and the data obtained was from routine laboratory work, this study was exempted from the attainment of ethical approval. Authors’ Contributions All authors contributed to the conceptualization and implementation of the study. All authors contributed to analyzing the data, writing and reviewing of the manuscript.

Figures

Fig. 1
Fig. 1
Exclusion and inclusion criteria included in the study.
Fig. 2
Fig. 2
Yearly distribution of Enterobacteriaceae isolates in ( A ) ICUs, ( B ) wards, and ( C ) OPDs. ICU, intensive care unit; OPD, outpatient department.
See this image and copyright information in PMC

References

    1. Golkar Z, Bagasra O, Pace D G. Bacteriophage therapy: a potential solution for the antibiotic resistance crisis. J Infect Dev Ctries. 2014;8(02):129–136. - PubMed
    1. Centers for Disease Control and Prevention. Office of infectious disease antibiotic resistance threats in the United States, 2013. 2013. Available at: http://www.cdc.gov/drugresistance/threat-report-2013. Accessed July 4, 2020
    1. Lushniak B D. Antibiotic resistance: a public health crisis. Public Health Rep. 2014;129(04):314–316. - PMC - PubMed
    1. Rossolini G M, Arena F, Pecile P, Pollini S. Update on the antibiotic resistance crisis. Curr Opin Pharmacol. 2014;18:56–60. - PubMed
    1. Niederman M S. Impact of antibiotic resistance on clinical outcomes and the cost of care. Crit Care Med. 2001;29 04:N114–N120. - PubMed