Resistance of Escherichia coli and Klebsiella pneumoniae Isolated from Blood Samples at A University Hospital: A Six-Year Evaluation Comparative to the COVID-19 Pandemic Period

Abstract

Bloodstream infections (BSI) are among the most important nosocomial infections with high mortality and morbidity. Escherichia coli and Klebsiella pneumoniae are two of the most common bacteria causing BSI among Gram-negative bacteria. Antimicrobial resistance is one of the biggest problems in the treatment of infections caused by these bacteria. Monitoring the resistance process is important in determining the course of resistance and guiding empirical treatment. In this study, it was aimed to evaluate the resistance rates of K. pneumoniae and E. coli isolated from blood samples and to present the current data in our hospital. In the study, the resistance rates of E. coli and K. pneumoniae isolated from blood samples in 2016-2021 against antibiotics were analyzed retrospectively by taking the data of the laboratory information system. In the study, 659 E. coli and 304 K. pneumoniae were isolated from 963 blood cultures. Of these bacteria, 34% were isolated from intensive care units and 66% from patients hospitalized in other clinics. When all antibiotics were evaluated, it was observed that resistance rates were higher in patients hospitalized in intensive care units. The most effective antibiotic was amikacin. Extended-spectrum beta-lactamase (ESBL) positivity was 51% in intensive care unit isolates, while this rate was 36% in other clinics. Resistance rates were significantly higher in ESBL positive isolates. A significant difference was observed between pre-pandemic and pandemic periods in amikacin and meropenem resistance rates in K. pneumoniae isolates. It would be beneficial for health centers in our country to determine their own antibiotic use policies by considering scientific data. Therefore, we think that the results of this study may be a guide in determining the empirical treatment models to be applied in sepsis caused by E. coli and K. pneumoniae.