Antibiotic resistance profiles of endotracheal aspirates in intensive care unit patients

Abstract

AimInfectious agents of the lower respiratory tract in patients hospitalized in intensive care units (ICUs) are nosocomial pathogens that cause severe morbidity and mortality. The aim of this study was to determine bacterial growth and antibiotic resistance profiles of bacteria isolated from endotracheal aspirate (ETA) cultures obtained from ICUs of our hospital during a 1-year period.MethodBetween October 2017 and September 2018, ETA samples from adult intensive care units were retrospectively examined. In addition to conventional methods, bacterial identification and antibiotic susceptibility testing were performed according to the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) using the fully automated VITEK system (bioMérieux, France).ResultsOf the 205 ETA specimens obtained from adult ICUs, bacterial growth was detected in 113 samples from 103 patients. The isolated microorganisms were Acinetobacter baumannii (37; 32.7%), Pseudomonas aeruginosa (29; 25.6%), Staphylococcus aureus (13; 11.5%), Klebsiella pneumoniae (12; 10.6%), Escherichia coli (6; 5.3%), Enterobacter cloacae (4; 3.5%), and Stenotrophomonas maltophilia (2; 1.7%). Meropenem and imipenem resistance rates of A. baumannii were 89.1% for both antibiotics, whereas they were 48.2% and 51.7% for P. aeruginosa, respectively. Colistin and tigecycline resistance was not detected among the isolates. Oxacillin-resistant S. aureus strains were detected in 46.1% (6/13) of cases, while linezolid, teicoplanin, and vancomycin resistance were not observed.ConclusionIncreased carbapenem resistance among the most frequently isolated bacteria from ETA samples in the ICU highlights the importance of antimicrobial susceptibility testing for appropriate empirical treatment strategies.

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