Prevalence of Antibiotic Resistance Over Time in a Third-Level University Hospital

This study evaluated the spread and possible changes in resistance patterns of ESKAPE bacteria to first-choiceantibiotics from 2015 to 2019 at a third-level university hospital after persuasive stewardship measures wereimplemented. Isolates were divided into three groups (group 1, low drug-resistant; group 2, multidrug/extremely drug-resistant; and group 3, pan-resistant bacteria) and achi-squaredtest (v2) was applied to deter-mine differences in their distributions. Among the 2,521 isolates,Klebsiella pneumoniaewas the most fre-quently detected (31.1%). From 2015 to 2019, the frequency of isolates in groups 2and3 decreased from 70.1%to 48.6% (v2=63.439;p<0.0001). Stratifying isolates by bacterial species, forK. pneumoniae, the frequency ofPDR isolates decreased from 20% to 1.3% (v2=15.885;p=0.003). ForAcinetobacter baumannii, a statisticallysignificant decrease was found in groups 2and3: from 100% to 83.3% (v2=27.721;p<0.001). Also, forPseudomonas aeruginosaandEnterobacterspp., the frequency of groups 2and3 decreased from 100% to28.3% (v2=225.287;p<0.001) and from 75% to 48.7% (v2=15.408;p=0.003), respectively. These resultsindicate that a program consisting of persuasive stewardship measures, which were rolled out during the timeframe of our study, may be useful to control drug-resistant bacteria in a hospital setting.