Bacterial resistance in the intensive care unit of developing countries: Report from a tertiary hospital in Kazakhstan. (June 2019)

• Record Type: Journal Article
• Authors: Viderman, Dmitriy; Brotfain, Evgeni; Khamzina, Yekaterina; Kapanova, Gulnara; Zhumadilov, Agzam; Poddighe, Dimitri
• Is Part Of: Journal of global antimicrobial resistance. Volume 17(2019)
• Page Start: 35
• Page End: 38
• Publication Date: 2019-06
• Subjects: Antimicrobial resistance -- Hospital-acquired infection -- Intensive care unit -- Developing countries -- Carbapenems; Drug resistance -- Periodicals; Drug resistance -- Periodicals; Drug resistance; Periodicals; 616.9041
• DOI: 10.1016/j.jgar.2018.11.010
• Languages: English
• ISSNs: 2213-7165

Abstract

Highlights: The rates of ICU-related HAIs in Kazakhstan are ≥3 times greater than in Europe. Antimicrobial resistance rates in Kazakhstan ICUs are elevated. Resistance to carbapenems has been rapidly increasing in ICU-related HAIs. The variable availability of antibiotics is a major contributing factor. Abstract: Objectives: The aim of this study was to describe the patterns of antimicrobial resistance (AMR) of bacterial isolates causing hospital-acquired infections (HAIs) in the intensive care unit (ICU) of a tertiary hospital in Kazakhstan. Methods: This was a retrospective analysis of AMR in the ICU of the National Research Center for Oncology and Transplantation (Astana, Kazakhstan) during the year 2015. Results: During the study period, 546 patients were admitted to the ICU, of whom 135 (24.7%) developed at least one HAI. Most HAIs caused by Gram-positive bacteria were due to Enterococcus faecalis, which were resistant to aminoglycosides in >70% cases. Gram-negative bacteria were isolated in ca. 50% of cases, thus representing the greatest burden of HAIs. Very high resistance rates to ceftriaxone, cefotaxime and cefuroxime were observed. Moreover, Pseudomonas aeruginosa and Acinetobacter baumannii were resistant to carbapenems in <20% and in ca. 45% of cases, respectively. Conclusion: This study demonstrates the urgent need to implement more rational use of antimicrobials in Kazakhstan, which can be done only by establishing a proactive surveillance system along with an appropriate infection control programme.