Isolated Carbapenem Resistant Bacteria, Their Multidrug Resistant Profile, Percentage of Healthcare Associated Infection and Associated Mortality, in Hospitalized Patients in a University Hospital in Bratislava

Objectives: The absence of clinical studies in Slovakia on carbapenem-resistant K. pneumoniae, A. baumannii, and P. aeruginosa, makes planning and treatment strategies challenging and less effective. Our aim is to provide new clinical data on the percentage of healthcare-associated infection, antibiotic resistance profile, and mortality risk associated with these carbapenem-resistant bacteria in our department.

Methods: An observational, prospective, cross-sectional study was performed for a period of 15 months. Strain identification was performed after classical isolation and bio-chemical and cultivation methods. Antibiotic testing results were interpreted according to EUCAST guideline.

Result: Associated mortality risk was the highest in patients diagnosed with A. baumannii. The urinary tract was the most common site of isolation in all the three types of bacteria. Colistin was shown to be the most potent antibiotic among all the three types of bacteria, followed by aminoglycoside for K. pneumoniae and P. aeruginosa and ampicillin-sulbactam for A. baumannii.

Conclusion: A. baumannii poses the biggest challenge in the treatment and management of infected patients in our centre in Bratislava. Cephalosporins of the second to fourth generation, quinolones, tetracyclines, and cotrimoxazole are widely ineffective in the treatment of isolated bacteria. Reintroduction of colistin, despite its drug toxicity, can be considered as the last resort treatment I (Tab. 4, Fig. 4, Ref. 30).