Eight-year trends in the relative isolation frequency and antimicrobial susceptibility among bloodstream isolates from Greek hospitals: data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance - WHONET-Greece, 2010 to 2017

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 25; no. 34; p. 1
• Main Authors: Polemis, Michalis, Tryfinopoulou, Kyriaki, Giakkoupi, Panagiota, Vatopoulos, Alkiviadis
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 27-08-2020; European Centre for Disease Prevention and Control (ECDC)
• Subjects: Anti-Bacterial Agents - pharmacology; Antibiotics; Antimicrobial agents; Bacteremia - drug therapy; Bacteremia - epidemiology; Drug resistance; Drug Resistance, Bacterial; Gram-Negative Bacteria - classification; Gram-Negative Bacteria - drug effects; Gram-Negative Bacterial Infections - drug therapy; Gram-Negative Bacterial Infections - epidemiology; Gram-Negative Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Greece; Health surveillance; Hospitals, General; Humans; Microbial Sensitivity Tests - trends; Pathogens; Sentinel Surveillance; Surveillance; Greece; Greece; bloodstream infections; antimicrobial resistance; routine laboratory data; surveillance system; trend analysis
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.ES.2020.25.34.1900516

BackgroundAntimicrobial resistance (AMR) changes over time and continuous monitoring provides insight on trends to inform both empirical treatment and public health action.AimsTo survey trends in relative isolation frequency (RIF) and AMR among key bloodstream pathogens using data from the Greek Electronic System for the Surveillance of AMR (WHONET-Greece).MethodsThis observational study looked into routine susceptibility data of 50,488 blood culture isolates from hospitalised patients in 25 tertiary hospitals, participating in the WHONET-Greece for trends over time between January 2010 and December 2017. Only the first isolate per species from each patient was included. Hospital wards and intensive care units (ICUs) were analysed separately.ResultsDuring the study, the RIF of
increased in wards, as did the proportion of
isolates, which were non-susceptibleto most antibiotics in both wards and ICUs. Coincidently,
RIF declined while the respective rates of non-susceptible isolates to carbapenems and gentamicin increased.
RIF remained stable but decreasing proportions of non-susceptible isolates to all studied antibiotics, except imipenem were observed.
RIF increased as did the proportion of isolates non-susceptible to third-generation cephalosporins, carbapenems and fluoroquinolones. Concerning
, a decline in the percentage of meticillin resistant isolates in ICUs was found, while the percentages of
non-susceptibility to vancomycin stayed stable.ConclusionsRecognising these trends over time is important, since the epidemiology of AMR is complex, involving different 'bug and drug' combinations. This should be taken into consideration to control AMR.