The Assessment of Antimicrobial Resistance in Gram-Negative and Gram-Positive Infective Endocarditis: A Multicentric Retrospective Analysis
<i>Background and Objectives:</i> Multidrug-resistant microorganisms have made treating bacterial infections challenging. Resistance to antibiotics is expected to overcome efforts to produce new, effective antibacterial medication that is lifesaving in many situations. Infective endocard...
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| Format: | Article |
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MDPI AG
2023-02-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/3/457 |
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| author | Camelia Melania Budea Marius Pricop Ion Cristian Mot Florin George Horhat Kakarla Hemaswini Raja Akshay Rodica Anamaria Negrean Andrada Licinia Oprisoni Cosmin Citu Bogdan Andrei Bumbu Abduljabar Adi Ibrahim Khan Adelina Mavrea Iulia Bogdan Adrian Vasile Bota Roxana Manuela Fericean Iosif Marincu |
| author_facet | Camelia Melania Budea Marius Pricop Ion Cristian Mot Florin George Horhat Kakarla Hemaswini Raja Akshay Rodica Anamaria Negrean Andrada Licinia Oprisoni Cosmin Citu Bogdan Andrei Bumbu Abduljabar Adi Ibrahim Khan Adelina Mavrea Iulia Bogdan Adrian Vasile Bota Roxana Manuela Fericean Iosif Marincu |
| author_sort | Camelia Melania Budea |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> Multidrug-resistant microorganisms have made treating bacterial infections challenging. Resistance to antibiotics is expected to overcome efforts to produce new, effective antibacterial medication that is lifesaving in many situations. Infective endocarditis (IE) is a life-threatening infection that affects 5–15 per 100,000 patients annually and requires rapid antibiotic therapy to prevent morbidity and mortality. <i>Materials and Methods:</i> The present research assessed IE cases over five years, from a multicentric database, with the main objective of determining the degree of antibiotic resistance in these patients, stratified by Gram-positive and Gram-negative bacteria. <i>Results:</i> Bad oral hygiene was present in 58.6% of patients from the Gram-negative group (vs. 38.7% in the Gram-positive group). Non-valvular heart disease was identified in approximately 40% of all patients, and valvopathies in approximately 20%. It was observed that 37.9% of Gram-negative IE bacteria were resistant to three or more antibiotics, whereas 20.7% were susceptible. Among Gram-positive infections, <i>S. aureus</i> was the most commonly involved pathogen, with a multidrug-resistant pattern in 11.2% of patients, while <i>Acinetobacter baumannii</i> had the highest resistance pattern of all Gram-negative pathogens, with 27.4% of all samples resistant to three or more antibiotics. Patients with Gram-negative IE were 4.2 times more likely to die. The mortality risk was 4 times higher when bacteria resistant to two or more antibiotics was involved and 5.7 times higher with resistance patterns to three or more antibiotics than the reference group with no antibiotic resistance. Peripheral catheters were the most common cause of multi-resistant IE, followed by heart surgery, dental procedures, and ENT interventions. <i>Conclusions:</i> Even though Gram-positive infections were the most frequent (83.0% of all cases), Gram-negative IE infections are substantially more deadly than Gram-positive IE infections. However, it was also observed that patients with Gram-negative infections were more likely to have underlying comorbidities, be institutionalized, and be underweight. Although the Gram-negative infections were more severe, their resistance patterns were similar to Gram-positive bacteria. As resistance patterns increase, more efforts should be made to prevent a healthcare catastrophe. At the same time, careful prophylaxis should be considered in patients at risk, including those with central catheters, undergoing dental procedures, and with poor oral hygiene. |
| first_indexed | 2024-03-11T06:12:29Z |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T06:12:29Z |
| publishDate | 2023-02-01 |
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| series | Medicina |
| spelling | doaj.art-9a7edeb3bad74836a9af947140072dda2023-11-17T12:30:54ZengMDPI AGMedicina1010-660X1648-91442023-02-0159345710.3390/medicina59030457The Assessment of Antimicrobial Resistance in Gram-Negative and Gram-Positive Infective Endocarditis: A Multicentric Retrospective AnalysisCamelia Melania Budea0Marius Pricop1Ion Cristian Mot2Florin George Horhat3Kakarla Hemaswini4Raja Akshay5Rodica Anamaria Negrean6Andrada Licinia Oprisoni7Cosmin Citu8Bogdan Andrei Bumbu9Abduljabar Adi10Ibrahim Khan11Adelina Mavrea12Iulia Bogdan13Adrian Vasile Bota14Roxana Manuela Fericean15Iosif Marincu16Department of Ear-Nose-Throat, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDiscipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDepartment of Ear-Nose-Throat, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaMultidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaMalla Reddy Institute of Medical Sciences, Hyderabad 500055, IndiaMalla Reddy Institute of Medical Sciences, Hyderabad 500055, IndiaFaculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, RomaniaDepartment of Pediatrics, Discipline of Pediatric Oncology and Hematology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDepartment of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDepartment of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, RomaniaFaculty of General Medicine, Baskent University, 06790 Ankara, TurkeyFaculty of General Medicine, Baskent University, 06790 Ankara, TurkeyDepartment of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania<i>Background and Objectives:</i> Multidrug-resistant microorganisms have made treating bacterial infections challenging. Resistance to antibiotics is expected to overcome efforts to produce new, effective antibacterial medication that is lifesaving in many situations. Infective endocarditis (IE) is a life-threatening infection that affects 5–15 per 100,000 patients annually and requires rapid antibiotic therapy to prevent morbidity and mortality. <i>Materials and Methods:</i> The present research assessed IE cases over five years, from a multicentric database, with the main objective of determining the degree of antibiotic resistance in these patients, stratified by Gram-positive and Gram-negative bacteria. <i>Results:</i> Bad oral hygiene was present in 58.6% of patients from the Gram-negative group (vs. 38.7% in the Gram-positive group). Non-valvular heart disease was identified in approximately 40% of all patients, and valvopathies in approximately 20%. It was observed that 37.9% of Gram-negative IE bacteria were resistant to three or more antibiotics, whereas 20.7% were susceptible. Among Gram-positive infections, <i>S. aureus</i> was the most commonly involved pathogen, with a multidrug-resistant pattern in 11.2% of patients, while <i>Acinetobacter baumannii</i> had the highest resistance pattern of all Gram-negative pathogens, with 27.4% of all samples resistant to three or more antibiotics. Patients with Gram-negative IE were 4.2 times more likely to die. The mortality risk was 4 times higher when bacteria resistant to two or more antibiotics was involved and 5.7 times higher with resistance patterns to three or more antibiotics than the reference group with no antibiotic resistance. Peripheral catheters were the most common cause of multi-resistant IE, followed by heart surgery, dental procedures, and ENT interventions. <i>Conclusions:</i> Even though Gram-positive infections were the most frequent (83.0% of all cases), Gram-negative IE infections are substantially more deadly than Gram-positive IE infections. However, it was also observed that patients with Gram-negative infections were more likely to have underlying comorbidities, be institutionalized, and be underweight. Although the Gram-negative infections were more severe, their resistance patterns were similar to Gram-positive bacteria. As resistance patterns increase, more efforts should be made to prevent a healthcare catastrophe. At the same time, careful prophylaxis should be considered in patients at risk, including those with central catheters, undergoing dental procedures, and with poor oral hygiene.https://www.mdpi.com/1648-9144/59/3/457endocarditisantibioticsantimicrobial resistancebacterial infections |
| spellingShingle | Camelia Melania Budea Marius Pricop Ion Cristian Mot Florin George Horhat Kakarla Hemaswini Raja Akshay Rodica Anamaria Negrean Andrada Licinia Oprisoni Cosmin Citu Bogdan Andrei Bumbu Abduljabar Adi Ibrahim Khan Adelina Mavrea Iulia Bogdan Adrian Vasile Bota Roxana Manuela Fericean Iosif Marincu The Assessment of Antimicrobial Resistance in Gram-Negative and Gram-Positive Infective Endocarditis: A Multicentric Retrospective Analysis Medicina endocarditis antibiotics antimicrobial resistance bacterial infections |
| title | The Assessment of Antimicrobial Resistance in Gram-Negative and Gram-Positive Infective Endocarditis: A Multicentric Retrospective Analysis |
| title_full | The Assessment of Antimicrobial Resistance in Gram-Negative and Gram-Positive Infective Endocarditis: A Multicentric Retrospective Analysis |
| title_fullStr | The Assessment of Antimicrobial Resistance in Gram-Negative and Gram-Positive Infective Endocarditis: A Multicentric Retrospective Analysis |
| title_full_unstemmed | The Assessment of Antimicrobial Resistance in Gram-Negative and Gram-Positive Infective Endocarditis: A Multicentric Retrospective Analysis |
| title_short | The Assessment of Antimicrobial Resistance in Gram-Negative and Gram-Positive Infective Endocarditis: A Multicentric Retrospective Analysis |
| title_sort | assessment of antimicrobial resistance in gram negative and gram positive infective endocarditis a multicentric retrospective analysis |
| topic | endocarditis antibiotics antimicrobial resistance bacterial infections |
| url | https://www.mdpi.com/1648-9144/59/3/457 |
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