Multiresistance Determinants of Bacterial Agents in Patients with Nosocomial Pneumonia

Abstract

Nosocomial pneumonia is recognized as a common and serious complication in hospitals and other healthcare settings across the globe. It is one of the most common hospital-acquired infections, particularly among patients in intensive care units. The emergence of antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Gram-negative bacteria (Pseudomonas aeruginosa, Acinetobacter baumannii and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae), poses a growing challenge in the management of this infection. These pathogens may colonize healthcare environments and present a risk to hospitalized patients, especially those with underlying health conditions or undergoing invasive procedures.

Our research aimed to identify the predominant causative agents, to determine extended-spectrum beta-lactamases, and inducible clindamycin resistance in patients with nosocomial pneumonia while also contrasting these findings with isolates obtained from cases of community-acquired pneumonia (CAP). The study findings reveal a diverse bacterial spectrum associated with nosocomial pneumonia. Gram-negative bacteria were more prevalent (90.0% of cases), with P.aeruginosa being the most dominant (in 36.6% of cases). In cases of CAP, more prevalent was Gram-positive bacteria (80.0%). Among Gram-negative strains, ESBL, a key factor in multidrug resistance, was frequently identified at 88.8%, notably in all P. aeruginosa and A. baumannii strains. Additionally, MRSA strains with ICR, another determinant of multiresistance, were isolated from all staphylococcal strains obtained from patients with nosocomial infections. Identifying causative pathogens and their antimicrobial resistance determinants leads to antibiotic therapy and is crucial for improving patient outcomes and reducing the burden of healthcare-associated infections.