SavedAdd your journal

Journals / Anatolian Current Medical Journal / 2026 / Volume: 8 Issue: 6

Antimicrobial resistance of Gram-negative bacteria in intensive care unit-weighted blood culture isolates: a four-year retrospective single-center analysis covering the pandemic period

Safiye Göçer(LOKMAN HEKIM UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF BASIC MEDICAL SCIENCES (MEDICINE), DEPARTMENT OF MEDICAL MICROBIOLOGY (MEDICINE))0000-0003-1787-9755
Barış Ecevit Yüksel(LOKMAN HEKIM UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF SURGICAL MEDICINE, DEPARTMENT OF ANAESTHESIOLOGY AND REANIMATION)0000-0002-4136-8317
Pages
—
Publication Date
2026-10-25
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Given the increasing resistance observed in K. pneumoniae and A. baumannii, active surveillance and rational antibiotic use are critical to limiting the spread of resistant strains.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: This study, covering the period 2020-2023, examined the species distribution and resistance dynamics of Gram-negative bloodstream infections detected in a tertiary hospital.
📊
Key Findings & Data:Methods: Blood cultures collected at a tertiary hospital between January 2020 and December 2023 were retrospectively evaluated.
💡
Conclusion & Impact:Given the increasing resistance observed in K. pneumoniae and A. baumannii, active surveillance and rational antibiotic use are critical to limiting the spread of resistant strains.
🔬Design:Research Article
📍Scope:2020-2023 Verileri
⚙️Variables:Anti-bacterial agents · drug resistance · bacterial

Abstract

Aims: This study, covering the period 2020-2023, examined the species distribution and resistance dynamics of Gram-negative bloodstream infections detected in a tertiary hospital. The study aims to contribute to region-specific empirical treatment approaches by revealing changes in resistance, particularly in intensive care units (ICUs). Methods: Blood cultures collected at a tertiary hospital between January 2020 and December 2023 were retrospectively evaluated. The species distribution and antimicrobial resistance profiles of Gram-negative bacteria isolated from positive blood cultures were examined. Species identification and antibiotic susceptibility testing were performed using the BD Phoenix 100 system, and the results were evaluated according to EUCAST criteria. Repeated isolates were excluded. Appropriate parametric and non-parametric tests were used in the statistical analyses. Results: Of the 528 Gram-negative isolates examined, 83.5% were obtained from ICUs, with the most frequently isolated species being Klebsiella pneumoniae (K. pneumoniae) (25.8%), Acinetobacter baumannii (A. baumannii) (21.2%), and Escherichia coli (15.3%). Resistance rates were significantly higher in ICU isolates compared to ward isolates; imipenem resistance in K. pneumoniae showed a significant increase over the years (p=0.001), while resistance rates in A. baumannii isolates remained stable above 80% against all antibiotics. Amikacin exhibited the highest susceptibility rate (61.8%) among Enterobacterales isolates. Conclusion: The high resistance burden of Gram-negative bacteria originating from ICUs necessitates updating empirical treatment protocols with local surveillance data. Given the increasing resistance observed in K. pneumoniae and A. baumannii, active surveillance and rational antibiotic use are critical to limiting the spread of resistant strains.

🔖

Cite This Article

Göçer, S., Yüksel, B. E. (2026). Antimicrobial resistance of Gram-negative bacteria in intensive care unit-weighted blood culture isolates: a four-year retrospective single-center analysis covering the pandemic period. Anatolian Current Medical Journal, Volume: 8 Issue: 6. https://ajindex.com/articles/1667856

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (30)

  1. Holmes CL, Albin OR, Mobley HLT, Bachman MA. Bloodstream infections: mechanisms of pathogenesis and opportunities for intervention. Nat Rev Microbiol. 2025;23(4):210-224. doi:10.1038/s41579-024-01105-2
  2. Diekema DJ, Hsueh PR, Mendes RE, et al. The microbiology of bloodstream infection: 20-year trends from the SENTRY Antimicrobial Surveillance Program. Antimicrob Agents Chemother. 2019;63(7): e00355-19. doi:10.1128/AAC.00355-19
  3. Aslan MH, Vural M. Gram negative bacteria isolated from blood cultures and their antibiotic susceptibility. TSS. 2025;4(1):11-17. doi:10.61745/tss.1671441
  4. Gauba A, Rahman KM. Evaluation of antibiotic resistance mechanisms in Gram-negative bacteria. Antibiotics (Basel). 2023;12(11):1590. doi:10.3390/antibiotics12111590
  5. Lepe JA, Martínez-Martínez L. Resistance mechanisms in Gram-negative bacteria. Med Intensiva (Engl Ed). 2022;46(7):392-402. doi:10.1016/j.medine.2022.05.004
  6. Viasus D, Gudiol C, Carratalà J. Treatment of multidrug-resistant Gram-negative bloodstream infections in critically ill patients: an update. Curr Opin Crit Care. 2024;30(5):448-455. doi:10.1097/MCC.0000000000001190
  7. Tabah A, Lipman J, Barbier F, Buetti N, Timsit JF, On Behalf Of The Escmid Study Group For Infections In Critically Ill Patients-Esgcip. Use of antimicrobials for bloodstream infections in the intensive care unit, a clinically oriented review. Antibiotics (Basel). 2022;11(3):362. doi:10.3390/antibiotics11030362
  8. Jorwal A, Sharma S, Bairwa K, Sharma R, Rajni E. Silent crisis in the intensive care unit: current antimicrobial resistance landscape in an Indian hospital. J Postgrad Med. 2025;71(3):122-127. doi:10.4103/jpgm.jpgm_396_25
  9. Hussain Z, Farooqui F, Ibrahim A, Baig S. Patients and surfaces: integrated clinical-environmental surveillance of MDR Gram-negative bacteria in critical-care units (Karachi, 2024-2025). Microorganisms. 2025;13(12):2762. doi:10.3390/microorganisms13122762
  10. Al Souheil A, Hussein H, Jabbour Z, et al. Molecular epidemiological surveillance of carbapenem-resistant Gram-negative bacteria in Southern Lebanon. Antibiotics (Basel). 2025;14(11):1124. doi:10.3390/antibiotics14111124
  11. Timsit JF, Bassetti M, Cremer O, et al. Rationalizing antimicrobial therapy in the ICU: a narrative review. Intensive Care Med. 2019;45(2): 172-189. doi:10.1007/s00134-019-05520-5
  12. Munro C, Zilberberg MD, Shorr AF. Bloodstream infection in the intensive care unit: evolving epidemiology and microbiology. Antibiotics (Basel). 2024;13(2):123. doi:10.3390/antibiotics13020123
  13. Fabre V, Carroll KC, Cosgrove SE. Blood culture utilization in the hospital setting: a call for diagnostic stewardship. J Clin Microbiol. 2022; 60(3):e0100521. doi:10.1128/JCM.01005-21
  14. Li Y, Ren L, Zou J. Risk factors and prevention strategies of nosocomial infection in geriatric patients. Can J Infect Dis Med Microbiol. 2019;2019: 6417959. doi:10.1155/2019/6417959
  15. Sakagianni A, Koufopoulou C, Koufopoulos P, Feretzakis G, Koumaki V. The impact of COVID-19 on the epidemiology of carbapenem resistance. Antibiotics (Basel). 2025;14(9):916. doi:10.3390/antibiotics14090916
  16. Golli AL, Zlatian OM, Cara ML, Olteanu M. Pre-and post-COVID-19 antimicrobial resistance pattern of pathogens in an intensive care unit. Pharmaceuticals (Basel). 2024;17(4):407. doi:10.3390/ph17040407
  17. Gürbüz M, Türkekul Şen E, Esen B. COVID-19 öncesi dönemde ve COVID-19 pandemisi sırasında yoğun bakımda yatan hastalardan izole edilen bakteriyel ve fungal etkenlerin değerlendirilmesi ve antibiyotik duyarlılıklarının karşılaştırılması. Kocatepe Tıp Derg. 2024;25(1):86-93. doi:10.18229/kocatepetip.1235556
  18. Sargın-Altunok E, Keske Ş, Batırel A, et al. Impact of the COVID-19 pandemic on CLABSI rates and antibiotic resistance: a multicenter study in Turkiye. Infect Dis Clin Microbiol. 2025;7(3):273-282. doi:10.36519/idcm.2025.513
  19. World Health Organization. Global antibiotic resistance surveillance report 2025. Geneva: World Health Organization; 2025.
  20. Çetin Ş, Özekinci T, Özmen M, Sarmış A, Koçoğlu ME. 2018-2021 yılları arasında Prof. Dr. Süleyman Yalçın Şehir Hastanesi’nde kan kültürlerinden izole edilen bakterilerin tür dağılımı ve Gram negatif bakterilerin antibiyotik duyarlılıkları. Turk Mikrobiyol Cemiy Derg. 2023;53(4):237-244. doi:10.54453/TMCD.2023.61224
  21. Dönmez B, Başar E, Yılmaz Ş. Kan kültürlerinden izole edilen Gram negatif bakterilerin dağılımı ve yıllara göre antibiyotik direncinin incelenmesi. Turk Mikrobiyol Cemiy Derg. 2025;55(4):235-245. doi:10.54453/TMCD.2025.93899
  22. Boral J, Genç Z, Pınarlık F, et al. The association between Acinetobacter baumannii infections and the COVID-19 pandemic in an intensive care unit. Sci Rep. 2022;12(1):20808. doi:10.1038/s41598-022-25493-8
  23. Şimşek Bozok T, Bozok T. Yoğun bakım ünitelerinde yatan hastaların kan kültürlerinden izole edilen mikroorganizma dağılımı ve antibiyotik duyarlılıkları: iki yıllık değerlendirme. Turk Hij Den Biyol Derg. 2022; 79(4):606-615. doi:10.5505/TurkHijyen.2022.26937
  24. Çeken N, Duran H, Kula Atik T. Kan kültüründen izole edilen Gram negatif bakterilerin dağılımı ve antibiyotik direnç oranları. Turk Hij Den Biyol Derg. 2022;79(3):451-460. doi:10.5505/TurkHijyen.2022.57983.
  25. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Ulusal Antimikrobiyal Direnç Sürveyans (UAMDS) Ağı 2022-2023 yıllık raporu. Ankara: T.C. Sağlık Bakanlığı; 2025.
  26. Kömeç S, Durmuş MA. Yetişkin yoğun bakım hastalarının kan kültürlerinde üreyen gram negatif bakteriler ve Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli ve Pseudomonas aeruginosa’nın dört yıllık kümülatif antibiyogram verileri. ANKEM Derg. 2025;39(2):41-49. doi:10.54962/ankemderg.1686910
  27. Yılmaz Ş, Aşgın N. Kan kültüründe sıklıkla izole edilen bakterilerin ve antibiyotik duyarlılık profillerinin yıllara göre dağılımı. ANKEM Derg. 2019;33(3):95-101. doi:10.5222/ankem.2019.095
  28. Gür H, Hazırolan G. Kan kültürlerinden izole edilen nonfermentatif Gram negatif bakterilerin dağılımının ve antibiyotik duyarlılık profillerinin belirlenmesi. ANKEM Derg. 2019;33(2):49-57. doi:10.5222/ankem.2019.1915
  29. Azak E, Karadenizli A, Vahaboğlu H. Bir üniversite hastanesinde çoklu ilaca dirençli Acinetobacter baumannii ile oluşan enfeksiyonların 15 yıllık ara ile risk faktörleri ve prognoz yönünden araştırılması. Sakarya Med J. 2024;14(2):149-163. doi:10.31832/smj.1430446
  30. Kerget B, Kerget F, Çelik K, Koç G. Silent pandemic in intensive care units: post-pandemic rise of extensively drug-resistant Acinetobacter baumannii and Klebsiella pneumoniae in ventilator-associated pneumonia. Tuberk Toraks. 2025;73(1):60-69. doi:10.5578/tt.2025011064