Dalia Adukauskienė¹, Juozas Žilinskas², Dovilė Valančienė ¹

¹Lithuanian University of Health Sciences, department of Intensive care, Kaunas, Lithuania

²Lithuanian University of Health Sciences, department of Radiology, Kaunas, Lithuania

ABSTRACT

The objective: to evaluate gram-negative rod (GNR) monobacteremia (MB) pathogens and their sensitivity to antibiotics in our intensive care unit.

Methods: a retrospective study of medical records of patients with GNR MB in our intensive care unit has been carried out.

Results: 68 cases of patients with GNR MB has been analyzed.  E.coli (n=24; 35.3%), K.pneumoniae (n=14; 20.6%) and Acinetobacter spp (n=8; 11.8%) were found more frequently (p=0.005) than other pathogens. E.coli MB was found in  abdominal cavity (n=9; 37.5%; p=0.004), Acinetobacter spp MB – in respiratory tract (n=4; 33.3%; p=0.011). Sensitivity to antibiotics of GNR: to ertapenem – 91.7% (p<0.001), to amikacin – 80.4% (p<0.001), to meropenem – 76.3% (p=0.002), to imipenem – 76.3% (p=0.002), to gentamicin – 64.2% (p=0.03), while sensitivity to piperacillin – 36.1% (p=0.04), to cefotaxime – 14.7% (p<0.001), to ampicillin – 9.6% (p<0.001). Multidrug resistance (MDR) was found in 34 (50.0%) cases (p=1). Strong relationship (Cramer‘s V=0.58) between inappropriate empirical antibiotic therapy and MDR was (n=22; 88.0%; OR 3.15; CI 1.9–5.2; p<0.001).

Conclusions: the most frequently isolated microorganisms of  GNR MB were E.coli, K.pneumoniae and Acinetobacter spp. The most often source of E.coli MB was found in  abdominal cavity, Acinetobacter spp. MB – in respiratory tract. GNR have presented with high sensitivity to carbapenems, amikacin and gentamicin, low sensitivity to ampicillin, piperacillin and cefotaxime, half of GNR was found to be MDR. Multidrug resistance increases the risk of using inappropriate empirical antibiotic therapy.

Key words: gram-negative rod monobacteremia, sensitivity to antibiotics, multidrug resistance.