Subject(s)
Colistin/pharmacology , Drug Resistance, Multiple, Bacterial , Escherichia coli Infections/microbiology , Escherichia coli/classification , Aged , Computational Biology , Escherichia coli/genetics , Escherichia coli/isolation & purification , Escherichia coli/pathogenicity , Escherichia coli Proteins/genetics , Greece , High-Throughput Nucleotide Sequencing , Humans , Multilocus Sequence Typing , Whole Genome Sequencing , beta-Lactamases/geneticsABSTRACT
In recent years, hospitals in southeastern Europe have faced dramatically high rates of antibiotic-resistant Acinetobacter baumannii. We analysed the evolution of resistance among clinical isolates of A. baumannii group obtained from nine tertiary hospitals throughout Greece over 6 years (2010-2015). Identification and antimicrobial susceptibility testing were performed using Vitek 2 or Microscan walkaway automated systems. Between 2010 and 2015, resistance to ampicillin/sulbactam increased from 46.2 to 88.2â% (P=0.021), resistance to gentamicin increased from 69.3 to 86.4â% (P=0.014) and resistance to tobramycin increased from 59.8 to 76.8â% (P=0.011). Imipenem resistance rates were consistently very high, ranging from 90.3â% in 2010 to 94.5â% in 2015 (P=0.198), while meropenem resistance rates increased from 82.6â% in 2010 to 94.8â% in 2015 (P=0.006). Resistance rates to trimethoprim/sulfamethoxazole showed a remarkable decreasing trend, declining from 90.2â% in 2010 to 69.1â% in 2015 (P=0.035). These evolutions render the treatment of A. baumannii infections particularly challenging and underline the need for enhanced infection control measures.