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Parascandalo FA, Zarb P, Tartari E, et al. Carriage of multidrug-resistant organisms in a tertiary university hospital in Albania-a point prevalence survey. Antimicrob Resist Infect Control. 2016;5:29doi: 10.1186/s13756-016-0128-1.
Parascandalo, F. A., Zarb, P., Tartari, E., Lacej, D., Bitincka, S., Manastirliu, O., Nika, D., & Borg, M. A. (2016). Carriage of multidrug-resistant organisms in a tertiary university hospital in Albania-a point prevalence survey. Antimicrobial resistance and infection control, 529. https://doi.org/10.1186/s13756-016-0128-1
Parascandalo, Falzon A, et al. "Carriage of multidrug-resistant organisms in a tertiary university hospital in Albania-a point prevalence survey." Antimicrobial resistance and infection control vol. 5 (2016): 29. doi: https://doi.org/10.1186/s13756-016-0128-1
Parascandalo FA, Zarb P, Tartari E, Lacej D, Bitincka S, Manastirliu O, Nika D, Borg MA. Carriage of multidrug-resistant organisms in a tertiary university hospital in Albania-a point prevalence survey. Antimicrob Resist Infect Control. 2016 Aug 05;5:29. doi: 10.1186/s13756-016-0128-1. eCollection 2016. PMID: 27499852; PMCID: PMC4975909.
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Antimicrob Resist Infect Control. 2016 Aug 05;5:29. doi: 10.1186/s13756-016-0128-1. eCollection 2016.

Carriage of multidrug-resistant organisms in a tertiary university hospital in Albania-a point prevalence survey.

Antimicrobial resistance and infection control

Falzon A Parascandalo, P Zarb, E Tartari, D Lacej, S Bitincka, O Manastirliu, D Nika, M A Borg

Affiliations

  1. Infection Control Unit, Mater Dei Hospital, Birkirkara Bypass, Msida, 2080 MSD Malta.
  2. University Hospital Centre, 'Mother Teresa', Tirana, Albania.

PMID: 27499852 PMCID: PMC4975909 DOI: 10.1186/s13756-016-0128-1

Abstract

BACKGROUND: Antimicrobial resistance has been recognised as a serious global Public Health problem. Prevalence of Multiple-Drug-Resistant (MDR) organism carriage in Albania is largely unknown since no national surveillance system is in place and few publications are accessible in the literature.

METHODS: A 1-day point-prevalence-survey (PPS) screening for nasal methicillin-resistant Staphylococcus aureus (MRSA) and rectal MDR Gram-negative carriage was carried out at the high-dependency wards in the country's only tertiary care hospital, in Tirana.

RESULTS: A total of 106 nasal and 104 rectal swabs were collected. 14.2 % of patients (95 % Confidence Interval [95 CI]: 8.1-22.3 %) were MRSA nasal carriers. Resistance to aminoglycosides and fluoroquinolones was common in these isolates (≥80 %) but no resistance was identified against glycopeptides, nitrofurantoin and the relatively newer agents, tigecycline and linezolid. Fifty Enterobacteriaceae isolates were cultivated from 33 of 104 screened patients (31.7 % [95 CI: 22.9-41.6 % 95 CI]). The prevalence of Extended Spectrum Beta-Lactamase (ESBL) production in Enterobacteriaceae was 41.3 % (95 CI: 31.8-51.4 %). The two more commonly isolated Enterobacteriaceae were E. coli ([n = 28], 24 ESBL positive; 1 AmpC positive and 3 without an identified mechanism of resistance) and Klebsiella pneumoniae ([n = 13], all ESBL positive; 1 also AmpC and metallo-β-lactamase (MBL) positive). Susceptibility to carbapenems (≥98 %), fosfomycin (90 %) and amikacin (70 + 20 % intermediate) was high but a high level of resistance to all other agents tested was noted. Non-fermenting Gram-negative bacilli were less commonly isolated {22 isolates: Acinetobacter baumannii (9); Pseudomonas aeruginosa (8) and Stenotrophomonas maltophilia (5)}.

CONCLUSION: Although a significant rate of MRSA carriage was identified, the main resistance challenge in Albania appears to be linked with Gram-negative organisms, particularly ESBL in Enterobacteriaceae.

Keywords: Antimicrobial-resistance; ESBL; Enterobacteriaceae; Infection-prevention; Meticillin resistant staphylococcus aureus (MRSA)

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