Comprehensive surveillance of antimicrobial susceptibility across adult and pediatric populations in Catalonia: Insights from community, hospital, and long-term care facility settings

Abstract

Background: This study presents comprehensive data on antimicrobial susceptibility across healthcare settings and age groups in Catalonia, Spain.

Methods: Susceptibility data were collected from 37 microbiology laboratories between 2020 and 2022 for community-acquired infections (CAIs), and 2021 and 2022 for hospital and long-term care facilities (LTCFs). Susceptibility was calculated based on the proportion of susceptible strains among the total strains.

Results: Pediatrics: Community-acquired infections (CAIs): in urinary tract infections (UTIs), extended-spectrum beta-lactamase production (ESBL-P) Escherichia coli was 3.8%. Streptococcus pneumoniae was highly susceptible to penicillins (97.5%). Community-acquired methicillin-resistant Staphylococcus aureus was 6.8%. Hospital-acquired infections (HAIs): ESBL-P in E. coli and Klebsiella pneumoniae were 6.7% and 9.4%. Carbapenem resistance in Enterobacter cloacae complex was less than 1%. Extremely drug-resistant Pseudomonas aeruginosa was 1.6%.

Adults: CAIs: In UTIs, E. coli showed high susceptibility to fosfomycin (>95%) and 9% of ESBL-P. In respiratory tract infections, Streptococcus pyogenes exhibited reduced susceptibility to macrolides (67%) and clindamycin (75.1%), while Haemophilus influenzae and S. pneumoniae remained susceptible to penicillins (78% and 96%). HAIs: E. coli showed 12.8% of ESBL-P and K. pneumoniae 20%. Carbapenem resistance was mainly identified in E. cloacae (2.8%) and K. pneumoniae (2.2%). P. aeruginosa showed high susceptibility to meropenem (87%). Methicillin-resistance was detected in 22% of S. aureus. Long-term care facilities (LTCFs): E. coli causing UTI was highly susceptible to carbapenems (99%), nitrofurantoin (96%), and fosfomycin (93%) with 25.8% of ESBL-P. K. pneumoniae showed 40% ESBL-P and 2.9% of carbapenem resistance. P. aeruginosa exhibited decreased susceptibility to quinolones (69.5%) and highly susceptibility to meropenem (88.5%).

Conclusion: The data underscore the necessity of stratified susceptibility reports by setting, type of infection, and age.

Keywords: Antimicrobial Stewardship Program; Antimicrobial resistance; Microbial susceptibility; Programas de optimización del uso de los antimicrobianos; Resistencia antimicrobiana; Sensibilidad microbiana.