The spread of antibiotic resistance poses a significant global health threat, emphasizing the need for robust epidemiological research to inform antimicrobial strategies. This study aimed to investigate antibiotic resistance patterns in Serratia marcescens isolates from clinical samples over a span of seven years at the University Hospital “San Giovanni di Dio e Ruggi d’Aragona” in Salerno, Italy.
𝘚𝘦𝘳𝘳𝘢𝘵𝘪𝘢 𝘮𝘢𝘳𝘤𝘦𝘴𝘤𝘦𝘯𝘴 is a notable opportunistic pathogen implicated in various clinical diseases, including pneumonia, keratitis, meningitis, and urinary tract and wound infections. Given the documented outbreaks of nosocomial infections by 𝘚𝘦𝘳𝘳𝘢𝘵𝘪𝘢 𝘮𝘢𝘳𝘤𝘦𝘴𝘤𝘦𝘯𝘴 strains, particularly in high-risk settings affecting immunocompromised patients and newborns, understanding the dynamics of antibiotic resistance in this pathogen is crucial for effective clinical management and infection control strategies.
Key Scientific Findings:
- Isolation Source and Prevalence:
- A total of 396 𝘚𝘦𝘳𝘳𝘢𝘵𝘪𝘢 𝘮𝘢𝘳𝘤𝘦𝘴𝘤𝘦𝘯𝘴 isolates were obtained from clinical samples, with the highest prevalence observed in broncho-aspirates and sputum (31.6%) and blood cultures (21.5%).
- Lower rates of isolation were noted in urine samples (5.8%) and catheters (4.3%), indicating reduced pathogenicity in the urinary system.
- Antibiotic Susceptibility:
- Ceftazidime/avibactam, amikacin, and trimethoprim/sulfamethoxazole demonstrated significant susceptibility among tested antibiotics.
- However, a troubling trend of increasing carbapenem resistance was identified over the seven-year observation period.
- Notably, amikacin exhibited a low resistance rate of 4.4%, highlighting its efficacy against 𝘚𝘦𝘳𝘳𝘢𝘵𝘪𝘢 𝘮𝘢𝘳𝘤𝘦𝘴𝘤𝘦𝘯𝘴 infections.
- Comparative Analysis:
- International studies revealed variations in isolation sources and antibiotic resistance profiles across different regions and time periods.
- Studies from China, Turkey, and Poland reported differing prevalence rates and antibiotic susceptibility patterns, emphasizing the need for localized surveillance efforts.
- Trend Analysis:
- The final two years of the study (2021–2022) saw a doubling in the number of 𝘚𝘦𝘳𝘳𝘢𝘵𝘪𝘢 𝘮𝘢𝘳𝘤𝘦𝘴𝘤𝘦𝘯𝘴 isolates, with an increasing prevalence in respiratory and blood culture samples.
- This upward trend underscores the evolving epidemiology of 𝘚𝘦𝘳𝘳𝘢𝘵𝘪𝘢 𝘮𝘢𝘳𝘤𝘦𝘴𝘤𝘦𝘯𝘴 infections and the importance of ongoing monitoring.
- Impact of COVID-19 Pandemic:
- Similar to findings from other regions, a decline in meropenem resistance rates in 2019–2020 was attributed to strict prevention and control measures implemented during the COVID-19 pandemic.
- The pandemic’s influence on antimicrobial resistance highlights the interconnectedness of infectious disease management and public health crises.
Methodology:
- Sample Collection: Clinical samples were collected from patients presenting with suspected 𝘚𝘦𝘳𝘳𝘢𝘵𝘪𝘢 𝘮𝘢𝘳𝘤𝘦𝘴𝘤𝘦𝘯𝘴 infections over a seven-year period.
- Identification and Antibiotic Susceptibility Testing: Isolates were identified using standard microbiological techniques, and antibiotic susceptibility testing was performed using the Vitek 2 system with EUCAST breakpoints.
- Comparative Analysis: Study findings were compared with international research studies to assess global trends in 𝘚𝘦𝘳𝘳𝘢𝘵𝘪𝘢 𝘮𝘢𝘳𝘤𝘦𝘴𝘤𝘦𝘯𝘴 antibiotic resistance.
This comprehensive epidemiological study provides valuable insights into the prevalence and antibiotic resistance patterns of 𝘚𝘦𝘳𝘳𝘢𝘵𝘪𝘢 𝘮𝘢𝘳𝘤𝘦𝘴𝘤𝘦𝘯𝘴 isolates in a clinical setting. By elucidating these dynamics, the study informs evidence-based approaches for infection control and antimicrobial stewardship, ultimately contributing to improved patient outcomes and public health.
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