Bacterial isolates from severe infections and their antibiotic susceptibility patterns in Italy: A nationwide study in the hospital setting

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

Research output: Contribution to journalArticlepeer-review

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%. Finally, Acinetobacter 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.

Original languageEnglish
Pages (from-to)589-602
Number of pages14
JournalJournal of Chemotherapy
Volume18
Issue number6
Publication statusPublished - Dec 2006

Keywords

  • Antibiotics
  • Hospital infection
  • Hospitals
  • Italy
  • Nosocomial infection
  • Resistance
  • Severe pathology

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Microbiology (medical)

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