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. 2023 Mar 21;12(6):2414.
doi: 10.3390/jcm12062414.

Evolution of Antibiotic Resistance in Escherichia coli and Klebsiella pneumoniae Clinical Isolates in a Multi-Profile Hospital over 5 Years (2017-2021)

Beata Mączyńska  1   2 , Magdalena Frej-Mądrzak  3 , Jolanta Sarowska  3 , Krystyna Woronowicz  4 , Irena Choroszy-Król  3 , Agnieszka Jama-Kmiecik  3
Affiliations

Evolution of Antibiotic Resistance in Escherichia coli and Klebsiella pneumoniae Clinical Isolates in a Multi-Profile Hospital over 5 Years (2017-2021)

Beata Mączyńska et al. J Clin Med. .

Abstract

In recent years, we have witnessed a growing drug resistance among bacteria, which is associated with the use and availability of an increasing number of broad-spectrum antimicrobial agents, as well as with their irrational and excessive use. The present study aims to analyze changes in the drug resistance of Gram-negative Enterobacterales: Escherichia coli and Klebsiella pneumoniae, isolated from infections in a multi-profile hospital over five years (from 2017 to 2021). Among the practical outcomes of the evaluation of these data will be the possibility of determining changes in susceptibility to the antibiotics used in the hospital. In turn, this will help propose new therapeutic options, especially for empirical therapy that is necessary in severe infections. The analysis of the use of individual groups of antibiotics allowed for identification of the causes of the increasing resistance of Gram-negative bacilli. The highest number of infections whose etiological agent was K. pneumoniae ESBL(+) and E. coli ESBL(+) was observed in 2018. In the analyzed five-year period, the number of multi-resistant (MDR) K. pneumoniae strains increased successively, which seems to be related to the growing use, especially in the pandemic period, of broad-spectrum antibiotics, mainly penicillins with inhibitors, third-generation cephalosporins, and carbapenems.

Keywords: ESBL; Enterobacteriaceae; multi-drug resistant strains.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparison of the number of E. coli ESBL(+) and ESBL(−) strains in 2017–2021.
Figure 2
Figure 2
Comparison of the percentage of E. coli ESBL(+) and ESBL(−) strains from 2017 to 2021.
Figure 3
Figure 3
Percentage of E. coli ESBL(−) strains resistant to penicillins (ampicillin) and penicillins with inhibitors.
Figure 4
Figure 4
Percentage of E. coli ESBL(+) strains resistant to penicillins with inhibitors.
Figure 5
Figure 5
Percentage of cephalosporin-resistant E. coli ESBL(−) strains.
Figure 6
Figure 6
Percentage of E. coli ESBL(+) strains resistant to cephalosporins.
Figure 7
Figure 7
Percentage of aminoglycoside-resistant E. coli ESBL(−) strains.
Figure 8
Figure 8
Percentage of E. coli ESBL(+) strains resistant to aminoglycosides.
Figure 9
Figure 9
Percentage of quinolone-resistant E. coli ESBL(−) strains.
Figure 10
Figure 10
Percentage of quinolone-resistant E. coli ESBL(+) strains.
Figure 11
Figure 11
Comparison of the number of K. pneumoniae ESBL(+) and ESBL(−) strains from 2017 to 2021.
Figure 12
Figure 12
Comparison of the percentage of K. pneumoniae ESBL(+) and ESBL(−) strains from 2017 to 2021.
Figure 13
Figure 13
Percentage of K. pneumoniae ESBL(−) resistant strains with inhibitor penicillins.
Figure 14
Figure 14
Percentage of K. pneumoniae ESBL(+) strains resistant to penicillins with inhibitors.
Figure 15
Figure 15
Percentage of cephalosporin-resistant K. pneumoniae ESBL(−) strains.
Figure 16
Figure 16
Percentage of K. pneumoniae ESBL(+) strains resistant to cephalosporins.
Figure 17
Figure 17
Percentage of K. pneumoniae strains resistant to carbapenems.
Figure 18
Figure 18
Comparison of the percentage of K. pneumoniae strains susceptible and resistant to carbapenems in 2021.
Figure 19
Figure 19
Percentage of K. pneumoniae ESBL(−) strains resistant to aminoglycosides.
Figure 20
Figure 20
Percentage of K. pneumoniae ESBL(+) strains resistant to aminoglycosides.
Figure 21
Figure 21
Percentage of K. pneumoniae ESBL(−) strains resistant to quinolones.
Figure 22
Figure 22
Percentage of K. pneumoniae ESBL(+) strains resistant to quinolones.
Figure 23
Figure 23
Consumption of antibiotics in all departments of the hospital over the past five years.
Figure 24
Figure 24
Consumption of quinolones (ciprofloxacin and levofloxacin) in 2017–2021.
Figure 25
Figure 25
Consumption of second-generation cephalosporins (cefuroxime), third-generation cephalosporins (cefotaxime, ceftriaxone, ceftazidime), fourth-generation cephalosporins (cefepime), and carbapenems (imipenem, meropenem) in 2017–2021.
Figure 26
Figure 26
Consumption of penicillins (ampicillin) and penicillins with inhibitors (amoxicillin with clavulanic acid, ampicillin with sulbactam, and piperacillin with tazobactam) in 2017–2021.
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