Nosocomial Infections in Tbilisi, Georgia: A Retrospective Study of Microbiological Data from 4 Major Tertiary Care Hospitals

Abstract

A study was conducted to evaluate the epidemiology of nosocomial pathogens and their resistance patterns at 4 major tertiary care centres in Tbilisi, Georgia, USA. A 3-year retrospective descriptive analysis of microbiological data collected during the period 2007-2010 from 4 major tertiary health care centres in Tbilisi, Georgia, was performed. A total of 3452 available clinical samples were included in the study, and positive findings were documented for 1607 cultures (46. 6%). The most commonly isolated microorganisms included Klebsiella pneumoniae (in 26.5% of samples), Pseudomonas aeruginosa (15.2%), Candida albicans (12.3%), Staphylococcus aureus (9%), Escherichia coli (7.6%), and Acinetobacter baumannii (5.1%). Among 95 GNR isolates tested for the presence of extended-spectrum beta -lactamase (ESBL), 33.7% were found to be ESBL carriers. Extensive resistance to different groups of antibiotics was found among GNRs, including resistance to carbapenems. Only 29% and 11.9% of Pseudomonas and Acinetobacter isolates, respectively, were susceptible to imipenem. The vast majority of GNRs showed susceptibility to colistin, but we identified 8 colistin-resistant isolates, which included P. aeruginosa, K. pneumoniae, Proteus, and E. coli. The most common Gram-positive cocci (GPC) recovered were S. aureus, Staphylococcus epidermidis, and Enterococcus faecalis; 33.3% of S. aureus isolates and 36.1% of S. epidermidis isolates were methicillin-resistant. All of the GPC isolates were vancomycin-susceptible. Overall, 66 faecal samples from 53 patients with diarrhoea that developed during their hospitalization were evaluated for the presence of C. difficile A and B toxins; 20 patients (37.7%) had culture results positive for C. difficile.