Prevalence of Multidrug-Resistant Pathogens Causing Bloodstream Infections in an Intensive Care Unit

Figures & data

Figure 1 Distribution by gender and age of the patients admitted to the intensive care unit (ICU) of emergency clinical county hospital of craiova, Romania, 2017–2020 (Absolute numbers).

Table 1 Distribution of the Microorganisms Isolated from Blood Samples from ICU Patients at Emergency Clinical County Hospital of Craiova, Romania, 2017–2020

Microorganism	Year
	2017	2018	2019	2020	2017–2020
	N=, (%)	N=, (%)	N=, (%)	N=, (%)	N=, (%)
MRSA	28 (48.28)	10 (17.24)	11 (18.96)	9 (15.52)	58 (100)
MSSA	0 (0)	0 (0)	2 (50)	2 (50)	4 (100)
CoNS	19 (5.98)	70 (22.01)	94 (29.56)	135 (42.45)	318 (100)
Streptococcus gallolyticus	2 (40)	0 (0)	0 (0)	3 (60)	5 (100)
Enterococcus faecalis	4 (9.52)	6 (14.29)	8 (19.05)	24 (57.14)	42 (100)
Escherichia coli	5 (18.52)	6 (22.22)	4 (14.82)	12 (44.44)	27 (100)
Klebsiella pneumoniae	10 (14.29)	8 (11.43)	14 (20)	38 (54.28)	70 (100)
Proteus mirabilis	2 (25)	1 (12.50)	2 (25)	3 (37.50)	8 (100)
Pseudomonas aeruginosa	1 (5)	1 (5)	13 (65)	5 (25)	20 (100)
Acinetobacter baumannii	3 (6.67)	14 (31.11)	14 (31.11)	14 (31.11)	45 (100)
NFB	4 (36.36)	2 (18.18)	4 (36.36)	1 (9.10)	11 (100)
Enterobacter cloacae	1 (25)	0 (0)	1 (25)	2 (50)	4 (100)
Citrobacter freundii	2 (66.67)	1 (33.33)	0 (0)	0 (0)	3 (100)
Providencia stuartii	0 (0)	0 (0)	1 (50)	1 (50)	2 (100)
Total	81 (13.12)	119 (19.28)	168 (27.22)	249 (40.35)	617 (100)

Abbreviations: MRSA, Methicillin-Resistant Staphylococcus aureus; MSSA, Methicillin-Susceptible Staphylococcus aureus; CoNS, Coagulase-negative staphylococci; NFB, nonfermenting Gram-negative bacteria.

Figure 2 Distribution by gender of the most common microorganisms isolated from blood samples from patients hospitalized in ICU, emergency clinical county hospital Craiova, Romania, between 2017–2020.

Figure 3 Distribution by age groups of the most common microorganisms isolated from blood samples from patients hospitalized in ICU, emergency clinical county hospital Craiova, Romania, between 2017–2020.

Figure 4 Trend of most frequent multi-drug resistance (MDR) microbial isolates from blood samples from patients hospitalized in ICU, emergency clinical county hospital Craiova, Romania, between 2017–2020.

Table 2 Antimicrobial Resistance Pattern of Enterobacteriaceae GNB (Number and Percentage) from Blood Samples from ICU Patients at Emergency Clinical County Hospital Craiova, Romania, 2017–2020

Antimicrobial Agent	Klebsiella pneumoniae (N=70)	Escherichia coli (N=27)	Proteus mirabilis (N=8)
	N=, (%)	N=, (%)	N=, (%)
Ampicillin	66 (94.28)	18 (66.66)	4 (50)
Amoxicillin/ clavulanic acid	55 (78.57)	5 (27.77)	4 (50)
Amikacin	28 (40)	1 (3.70)	1 (12.5)
Aztreonam	54 (77.14)	4 (14.81)	0 (0)
Cefepime	51 (72.85)	3 (11.11)	1 (12.5)
Cefotaxime	57 (81.42)	6 (22.22)	1 (12.5)
Cefoxitin	47 (67.14)	2 (7.40)	1 (12.5)
Ceftazidime	58 (82.85)	8 (29.62)	2 (25)
Ceftriaxone	57 (81.42)	9 (33.33)	2 (25)
Cefuroxime	11 (15.71)	3 (11.11)	1 (12.5)
Ciprofloxacin	58 (82.85)	8 (29.62)	3 (37.5)
Levofloxacin	49 (70)	10 (37.03)	3 (37.5)
Moxifloxacin	44 (62.85)	7 (25.92)	2 (25)
Colistin	8 (11.42)	5 (18.51)	8 (100)^a
Ertapenem	52 (74.28)	1 (3.70)	0 (0)
Imipenem	41 (58.57)	1 (3.70)	6 (75)
Meropenem	50 (71.42)	1 (3.70)	0 (0)
Gentamicin	36 (51.42)	3 (11.11)	2 (25)
Piperacillin/tazobactam	54 (77.14)	3 (11.11)	1 (12.5)
Tobramycin	54 (77.14)	4 (14.81)	3 (37.5)
Tetracycline	40 (57.14)	8 (29.62)	8 (100)
Tigecycline	10 (14.28)	1 (3.70)	5 (62.5)
Chloramphenicol	44 (62.85)	3 (11.11)	4 (50)

Note: ^aProteus is inherently resistant to colistin.

Table 3 Antimicrobial Resistance Pattern of Gram Positive Coci (Number and Percentage) from Blood Samples from ICU Patients at Emergency Clinical County Hospital Craiova, Romania, 2017–2020

Antimicrobial Agent	MRSA N=58	CoNS N=318	Enterococcus faecalis N=42
	N=, (%)	N=, (%)	N=, (%)
Ciprofloxacin	42 (72.41)	189 (59.43)	35 (83.33)
Clindamycin	46 (79.31)	188 (59.12)	8 (19.04)
Erythromycin	51 (97.93)	232 (72.96)	37 (88.09)
Gentamicin	35 (60.34)	158 (49.69)	5 (11.90)
Levofloxacin	15 (25.86)	153 (48.11)	22 (52.38)
Linezolid	2 (3.44)	32 (10.06)	5 (11.90)
Moxifloxacin	40 (68.96)	181 (56.92)	6 (14.28)
Oxacillin	58 (100)^a	233 (73.27)	–^b
Penicillin	58 (100)	251 (78.93)	13 (30.95)
Rifampicin	30 (51.72)	143 (44.97)	–^b
Teicoplanin	8 (13.79)	28 (8.81)	4 (9.52)
Tetracycline	37 (63.79)	222 (69.81)	25 (59.52)
Tigecycline	–^b	1 (0.31)	1 (2.38)
Vancomycin	4 (6.89)	21 (6.60)	9 (21.42)

Notes: ^aMRSA is 100% resistant to oxacillin by definition. ^bPartially tested or not tested.

Table 4 Antimicrobial Resistance Pattern of Non-Fermenting GNB (Number and Percentage) from Blood Samples from ICU Patients at Emergency Clinical County Hospital Craiova, Romania, 2017–2020

Antimicrobial Agent	Acinetobacter baumannii N=45	Pseudomonas aeruginosa N=20	Other NF- GNB N=11
	N=, (%)	N=, (%)	N=, (%)
Amoxicillin/clavulanic acid	12 (26.66%)	–^a	2 (18.18%)
Aztreonam	17 (37.77%)	–^a	9 (81.81%)
Ceftazidime	40 (88.88%)	15 (75%)	5 (45.45%)
Ceftazidime	40 (88.88%)	15 (75%)	5 (45.45%)
Ceftriaxone	40 (88.88%)	–^a	7 (63.63%)
Cefotaxime	40 (88.88%)	15 (75%)	6 (54.54%)
Cefuroxime	40 (88.88%)	–^a	2 (18.18%)
Cefazolin	–^a	–^a	2 (18.18%)
Cefepime	40 (88.88%)	13 (65%)	8 (72.72%)
Ertapenem	–^a	2 (10%)	1 (9.09%)
Imipenem	38 (84.44%)	13 (65%)	5 (45.45%)
Meropenem	43 (95.55%)	15 (75%)	5 (45.45%)
Ciprofloxacin	43 (95.55%)	15 (75%)	9 (81.81%)
Levofloxacin	36 (80%)	14 (70%)	5 (45.45%)
Gentamicin	44 (97.77%)	13 (65%)	7 (63.63%)
Piperacillin/tazobactam	42 (93.33%)	15 (75%)	5 (45.45%)
Tetracycline	33 (73.33%)	2 (10%)	7 (63.63%)
Colistin	4 (8.88%)	2 (10%)	4 (36.36%)
Tigecycline	5 (11.11%)	12 (60%)	5 (45.45%)
Tobramycin	32 (71.11%)	15 (75%)	9 (81.81%)

Note: ^aPartially tested or not tested.