Academic Journal
Distribution of Non-Fermenting Gram-Negative Bacilli and Carbapenem Resistance Profiles in Intensive Care Units of a Foundation University Hospital: A 2023-2025 Retrospective Analysis.
| Τίτλος: | Distribution of Non-Fermenting Gram-Negative Bacilli and Carbapenem Resistance Profiles in Intensive Care Units of a Foundation University Hospital: A 2023-2025 Retrospective Analysis. |
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| Συγγραφείς: | Ozturk Akin H; Department of Medical Laboratory Techniques, Vocational School of Health Services, Istanbul Atlas University, Istanbul 34408, Türkiye., Unlu O; Department of Medical Microbiology, Faculty of Medicine, Istanbul Atlas University, Istanbul 34408, Türkiye. |
| Πηγή: | Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2026 Sep 08; Vol. 62 (9). Date of Electronic Publication: 2026 Sep 08. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: MDPI Country of Publication: Switzerland NLM ID: 9425208 Publication Model: Electronic Cited Medium: Internet ISSN: 1648-9144 (Electronic) Linking ISSN: 1010660X NLM ISO Abbreviation: Medicina (Kaunas) Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2018- : Basel, Switzerland : MDPI Original Publication: Kaunas : Lietuvos gydytojų sąjunga |
| Ιατρικοί όροι (MeSH): | Carbapenems*/pharmacology , Carbapenems*/therapeutic use , Gram-Negative Bacteria*/drug effects , Gram-Negative Bacteria*/isolation & purification, Intensive Care Units/statistics & numerical data ; Intensive Care Units/organization & administration ; Hospitals, University/organization & administration ; Hospitals, University/statistics & numerical data ; Turkey/epidemiology ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Gram-Negative Bacterial Infections/epidemiology ; Colistin/pharmacology ; Humans ; Retrospective Studies ; Microbial Sensitivity Tests ; Drug Resistance, Bacterial ; Male ; Female |
| Περίληψη: | Background and Objectives: Non-fermenting Gram-negative bacilli (NFGNB) are frequently recovered from respiratory specimens in intensive care units (ICUs) and are increasingly carbapenem-resistant. We described their distribution and resistance profiles in adult ICUs over three years. Materials and Methods: Respiratory specimens submitted from adult ICUs of a foundation university hospital in Istanbul between 6 January 2023 and 27 December 2025 were analysed retrospectively using laboratory information system data. Identification and susceptibility testing used the BD Phoenix M50 system with year-specific EUCAST breakpoints (v13.0-v15.0); colistin MICs were determined by broth microdilution. The number of patients contributing more than one isolate was 268. Accordingly, the primary trend analysis was performed using generalised estimating equations (GEE) accounting for within-patient clustering. Chi-square and first-isolate analyses were used as secondary and sensitivity analyses. Results: A total of 1407 isolates were recovered from 654 of 1194 patients with a respiratory culture. Acinetobacter spp. predominated (56.9% of isolates; 54.3% of patients), followed by Pseudomonas spp. (29.4%) and Stenotrophomonas maltophilia (11.1%). Carbapenem resistance in Acinetobacter spp. was 96.7% (95% CI 95.3-97.8) for imipenem and 96.6% (95.1-97.7) for meropenem, without temporal trend. In P. aeruginosa, meropenem resistance rose from 44.7% to 71.4% (GEE odds ratio per year 1.45, 95% CI 1.09-1.92, p = 0.011), whereas imipenem resistance did not change significantly. Among the agents tested, colistin was found to be the most effective (22.4% resistance in Acinetobacter spp. and 13.1% in P. aeruginosa). Ceftazidime-avibactam resistance in P. aeruginosa was 24.3%. Of the S. maltophilia isolates, 85.8% were categorised as susceptible-increased exposure to trimethoprim-sulfamethoxazole. Conclusions: Carbapenem resistance is high and stable in Acinetobacter spp. but rising for meropenem in P. aeruginosa. These data do not distinguish colonisation from infection and cannot be linked to clinical outcomes. They should therefore be used to inform local empirical-treatment policy alongside clinical assessment, rather than as evidence of treatment failure. |
| References: | Biometrics. 1986 Mar;42(1):121-30. (PMID: 3719049) JAMA. 1995 Aug 23-30;274(8):639-44. (PMID: 7637145) BMC Infect Dis. 2025 Dec 3;25(1):1691. (PMID: 41339825) Intensive Care Med. 2016 May;42(5):817-828. (PMID: 26880091) BMC Infect Dis. 2006 Oct 25;6:155. (PMID: 17064415) Cureus. 2025 Jul 27;17(7):e88844. (PMID: 40873850) J Infect Dev Ctries. 2021 Mar 07;15(2):254-262. (PMID: 33690209) Clin Microbiol Infect. 2025 Sep;31(9):1491-1499. (PMID: 40441355) JAC Antimicrob Resist. 2025 Mar 06;7(2):dlaf027. (PMID: 40051884) Crit Care. 2018 Apr 16;22(1):93. (PMID: 29656714) Cureus. 2024 Sep 28;16(9):e70375. (PMID: 39469379) Braz J Infect Dis. 2024 Jan-Feb;28(1):103705. (PMID: 38065221) Clin Microbiol Infect. 2020 Nov;26(11):1559.e1-1559.e4. (PMID: 32835792) Antibiotics (Basel). 2025 Mar 19;14(3):. (PMID: 40149132) JAMA. 2020 Apr 21;323(15):1478-1487. (PMID: 32207816) BMC Microbiol. 2025 Apr 16;25(1):218. (PMID: 40240992) Microbiol Spectr. 2024 Apr 2;12(4):e0383623. (PMID: 38483164) Antibiotics (Basel). 2025 Dec 19;15(1):. (PMID: 41594040) BMC Res Notes. 2020 Jul 2;13(1):319. (PMID: 32616058) PLoS One. 2025 Apr 16;20(4):e0319441. (PMID: 40238844) Clin Infect Dis. 2023 Jul 5;77(Suppl 1):S29-S37. (PMID: 37406041) BMC Infect Dis. 2025 Aug 21;25(1):1052. (PMID: 40841606) Infection. 2025 Feb;53(1):183-196. (PMID: 38990473) BMC Microbiol. 2025 Nov 14;25(1):741. (PMID: 41239232) Pathogens. 2025 Nov 14;14(11):. (PMID: 41305401) Chest. 2005 Dec;128(6):3854-62. (PMID: 16354854) Ann Palliat Med. 2020 Jul;9(4):1545-1555. (PMID: 32692197) BMJ Open. 2025 Jul 15;15(7):e092753. (PMID: 40664412) Int J Antimicrob Agents. 2007 May;29 Suppl 3:S33-41. (PMID: 17659210) Antibiotics (Basel). 2021 Oct 09;10(10):. (PMID: 34680807) Cureus. 2026 Jan 13;18(1):e101482. (PMID: 41694849) JAC Antimicrob Resist. 2025 Jul 29;7(4):dlaf134. (PMID: 40735512) |
| Contributed Indexing: | Keywords: Acinetobacter baumannii; Pseudomonas aeruginosa; Turkey; antimicrobial stewardship; antimicrobial susceptibility; carbapenem resistance; intensive care unit; non-fermenting Gram-negative bacteria; resistance surveillance |
| Substance Nomenclature: | 0 (Carbapenems) 0 (Anti-Bacterial Agents) Z67X93HJG1 (Colistin) |
| Entry Date(s): | Date Created: 20260926 Date Completed: 20260926 Latest Revision: 20260929 |
| Update Code: | 20260929 |
| PubMed Central ID: | PMC13608931 |
| DOI: | 10.3390/medicina62091728 |
| PMID: | 42796335 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1648-9144 |
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| DOI: | 10.3390/medicina62091728 |