Evis Nushi1, Sandër Marku2, Marinela Leka1, Leon Kaza1, Blerta Kika Brati3
1Regional Hospital, Lezha, Albania;
2Local Primary Health Care Unit, Lezha, Albania;
3Institute of Public Health, Tirana, Albania.
Aim: Antimicrobial resistance is one of the most worrisome issues of the century associated with a high cost of healthcare. Infections with antibiotic-resistant bacteria are becoming a real threat.
Therefore, monitoring of the antimicrobial resistance profile is necessary to control the spread of resistant bacteria. The aim of this study is to determine the antimicrobial resistance profile of infectious agents in patients hospitalized at Lezha Regional Hospital.
Methods: This is a prospective study, conducted during April 2019 – January 2020. Clinical samples were collected from patients hospitalized at Lezha Hospital. Identification of the isolates was performed: with EnteroPluri Test for enterobacteriaceas, OXI / FERMTMPluri Test – non-fermentable bacteria, StreptoSystem 12R – streptococci and StaphSystem 18R – staphylococci. The antibiogram was performed according to the EUCAST disc diffusion method and the interpretation was performed on the basis of EUCAST Breakpoint Tables v. 9.0.
Results: 398 specimens were collected, 195 feaces for stool cultures (48.9%), 109 urine (27.3%), 25 pus (6.2%), 20 vaginal swabs (5.0%), 18 blood for hemoculture (4.5%), 15 throat swabs (3.7%). %), 16 sputum (40.0%). Out of these, 337 (84.7%) cultures were negative and 61 (15.3%) positive.
Overall, Escherichia coli, was the predominant strain, 25 (40.9%), followed by Staphylococcus aureus 22 (36.1%), Klebsiella pneumoniae 3 (4.9%), Streptococcus pyogenes 3 (4.9%), Pseudomonas aeruginosa 2 (3.3%), Citrobacter freundi 2 (3.3%), Plesiomonas spp 2 (3.3%), Enterobacter cloacae 1 (1.6%), Enterococcus spp 1 (1.6%). A total of gram- negative strains (Enterobacteriaceae and Non-Fermenters) 35 (53.4%) and 26 (42.6%) gram-positive strains were isolated. The resistance of gram-negative strains was 57.1% to ceftriaxone and ampicillin, 34.3% to ciprofloxacine and nitrofurantoin, 31.4% to gentamicin and 28.6% to sulfomethoxazol-trimethoprime. The resistance of gram-positive strains was 42.3% to erythromycin, clindamycin and ceftriaxone, 26.9% to ampicillin and nitrofurantoin 23.1% to sulfomethoxazole-trimethoprime, 19.2% to ciprofloxacine and 11.5% to gentamicin.
Conclusions: The profile of antimicrobial resistance is quite high. This requires coordinated efforts to prevent the spread of infections by these strains as well as antimicrobial resistance through the use of antibiotic criteria.
Keywords: Lezha Regional Hospital microbial resistance profile, microbial resistance, strains.