Antimicrobial Resistance (AMR) Situation in Buddhachinaraj Phitsanulok Hospital, 2021-2023

Antimicrobial Resistance (AMR) Situation, 2021-2023

Abstract

Antimicrobial resistance (AMR) has been ranked as one of the top 10 global health threats. This retrospective descriptive study aimed to investigate the situation of AMR in nine monitored pathogens in bloodstream infections at Buddhachinaraj Phitsanulok Hospital from 2021 to 2023. The results indicated that Escherichia coli was the most commonly identified resistant pathogen (32%), followed by Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus. The infections were more frequently community-acquired (51.1%) than hospital-acquired (41.7%). The most common pathogen in the community was E. coli (47.1%), while in hospitals, it was Ac. baumannii (35.3%). Among the pathogens, Ac. baumannii exhibited the highest mortality rate. Pathogens showing a decline in drug resistance included CRAB (88% to 83%), 3GC-KP (53% to 51%), VRE (34% to 12%), and MRSA (21% to 20%). Conversely, resistance increased in CRKP (38% to 39%), 3GC-EC (33% to 38%), and CRPA (22% to 34%). The incidence of bloodstream infections caused by CRAB, CRKP, and VRE per 100,000 tested patients decreased, whereas it increased for CREC, CRPA, and MRSA. Hospital mortality rates were higher for infections with CRKP, CRPA, and VRE; with VRE showing the highest mortality rate. This study underscores the growing challenge of antimicrobial-resistant infections in both community and hospital settings. The implementation of effective infection control measures is essential for reducing mortality and preventing the further spread of AMR.