Authors: Nicoletti, G.; Schito, G.; Fadda, G.; Boros, S.; Nicolosi, D.; Marchese, A.; Spanu, T.; Pantosti, A.; Monaco, M.; Rezza, G.; Cassone, A.; Garaci, E.

Source: Journal of Chemotherapy, Number 6, December 2006 , pp. 589-602(14)

Publisher: Maney Publishing

Abstract:

The most frequent agents of severe bacterial infections and their antibiotic susceptibility patterns were determined in patients admitted to 45 Italian hospitals over the years 2002-2003. The most common diagnoses were: sepsis (33.8%), pneumonia (9.4%), intravascular catheter-associated infections (9.3%) and ventilator-associated pneumonia (8.1%). Overall, 5115 bacterial isolates were identified from 4228 patients. Three bacterial species, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli accounted for more than 50% of the isolates. Other prevalent bacterial isolates were Staphylococcus epidermidis and Enterococcus faecalis, while Acinetobacter baumanii ranked third among all Intensive Care Unit (ICU) isolates. 7% of S. aureus had intermediate resistance to vancomycin. Although E. faecalis displayed no vancomycin resistance, 34% of vancomycin-resistant isolates were found among Enterococcus faecium, one of the highest rates found to date, emphasizing the difference between these two enterococcal species. All the Gram-positive pathogens were susceptible to linezolid, with the exception of approximately 2% of the enterococcal isolates that were intermediate with a minimum inhibitory concentration (MIC)=4 μg/ml. Almost 10% of Escherichia coli, 14% of Klebsiella pneumoniae, 22% of Serratia marcescens and 50% of Enterobacter cloacae were non-susceptible to cefotaxime. Amikacin was the most active antibiotic against P. aeruginosa that showed lack of susceptibility to ceftazidime, gentamicin, piperacillin and ciprofloxacin ranging from 20 to 35%. FinallyAcinetobacter baumanii showed a high level of resistance to all the antibiotics tested including imipenem (58%). The results obtained in this study, the first of its kind in Italy, offer indications for guiding empirical therapy and implementing specific interventions to fight antibiotic-resistant bacterial infections and their transmission in the hospital setting in Italy.

Keywords: Italy; nosocomial infection; hospitals; Antibiotics; severe pathology; resistance; hospital infection

Document Type: Research Article

Publication date: 2006-12-01

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• By this author: Nicoletti, G. ;  Schito, G. ;  Fadda, G. ;  Boros, S. ;  Nicolosi, D. ;  Marchese, A. ;  Spanu, T. ;  Pantosti, A. ;  Monaco, M. ;  Rezza, G. ;  Cassone, A. ;  Garaci, E.

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