The Challenges of The Diagnostic and Therapeutic Approach of Patients with Infectious Pathology in Emergency Medicine

The emergency department (ED) represents an important setting for addressing inappropriate antimicrobial prescribing practices because of the time constraints and the duration of microbiological diagnosis. The purpose of this study is to evaluate the etiology and antimicrobial resistance (AMR) patte...

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Bibliographic Details
Main Authors: Silvia Ioana Musuroi, Adela Voinescu, Corina Musuroi, Luminita Mirela Baditoiu, Delia Muntean, Oana Izmendi, Romanita Jumanca, Monica Licker
Format: Article
Language:English
Published: MDPI AG 2023-12-01
Series:Journal of Personalized Medicine
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Online Access:https://www.mdpi.com/2075-4426/14/1/46
Description
Summary:The emergency department (ED) represents an important setting for addressing inappropriate antimicrobial prescribing practices because of the time constraints and the duration of microbiological diagnosis. The purpose of this study is to evaluate the etiology and antimicrobial resistance (AMR) pattern of the community-acquired pathogens, as well as the epidemiological characteristics of patients admitted through the ED, in order to guide appropriate antibiotic therapy. Methods: A retrospective observational study was performed on 657 patients, from whom clinical samples (urine, purulent secretions, blood cultures, etc.) were collected for microbiological diagnosis in the first 3 days after presentation in the ED. The identification of pathogens and the antimicrobial susceptibility testing with minimum inhibitory concentration determination were carried out according to the laboratory protocols. Results: From the 767 biological samples analyzed, 903 microbial isolates were identified. <i>E. coli</i> was most frequently isolated (24.25%), followed by <i>Klebsiella</i> spp., <i>S. aureus</i> (SA), and non-fermentative Gram-negative bacilli. <i>E. coli</i> strains maintained their natural susceptibility to most antibiotics tested. In the case of <i>Pseudomonas</i> spp. and <i>Acinetobacter</i> spp., increased rates of AMR were identified. Also, 32.3% of SA strains were community-acquired MRSA. Conclusions: The introduction of rapid microbiological diagnostic methods in emergency medicine is imperative in order to timely identify AMR strains and improve therapeutic protocols.
ISSN:2075-4426