Historical Overview of the Evolution of Multidrug-Resistant Gram-Negative Infections in Tunisia from 1999 to 2019

Historical Overview of the Evolution of Multidrug-Resistant Gram-Negative Infections in Tunisia from 1999 to 2019

<b>Background/Objectives</b>: As antimicrobial resistance patterns of Gram-negative bacteria change over time, this study aimed to analyze the antimicrobial susceptibility trends of <i>Escherichia coli</i>, <i>Klebsiella pneumoniae</i>, <i>Pseudomonas aerugi...

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Main Authors: Lamia Kanzari, Sana Ferjani, Basma Mnif, Faouzia Mahjoubi, Mariem Zribi, Khaoula Meftah, Asma Ferjani, Emna Mhiri, Yomna Ben Lamine, Yosr Kadri, Habiba Naija, Manel Hamdoun, Yosra Chebbi, Sarra Dhraief, Naglaa Mohamed, Hela Zaghden, Lamia Thabet, Wafa Achour, Olfa Bahri, Farouk Barguellil, Maha Mastouri, Sophia Besbes, Leila Slim, Hanen Smaoui, Adnene Hammami, Ilhem Boutiba-Ben Boubaker
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Antibiotics
Subjects:
Gram-negative bacteria
antibiotics
antimicrobial resistance
disk diffusion method
Tunisian hospitals
evolution
Online Access:https://www.mdpi.com/2079-6382/14/7/657
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Summary:<b>Background/Objectives</b>: As antimicrobial resistance patterns of Gram-negative bacteria change over time, this study aimed to analyze the antimicrobial susceptibility trends of <i>Escherichia coli</i>, <i>Klebsiella pneumoniae</i>, <i>Pseudomonas aeruginosa</i>, and <i>Acinetobacter baumannii</i> isolates in Tunisia. <b>Methods</b>: From 1999 to 2019, non-duplicate isolates of Gram-negative bacteria were collected from 11 Tunisian hospitals as part of an antimicrobial resistance surveillance program. Antimicrobial susceptibility testing was performed using the disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing guidelines. <b>Results</b>: Out of 213,434 isolates collected during the study period, 58.8% were <i>E. coli</i>, 22% were <i>K. pneumoniae</i>, 14.4% were <i>A. baumannii</i>, and 4.8% were <i>P. aeruginosa</i>, with 67% of the isolates sourced from urine samples. <i>E. coli</i> showed a significant increase in resistance to third-generation cephalosporins (3GC), from 5.4% in 2004 to 16.5% in 2019, but <i>K. pneumoniae</i> displayed a rising trend of resistance to imipenem, from 1% in 2005 to 18.6% in 2019; meanwhile, amikacin remained effective against <i>K. pneumoniae</i> isolates. <i>P. aeruginosa</i> did not exhibit a significant change in resistance to imipenem. <i>A. baumannii</i> had a high resistance rate to imipenem that increased from 34.5% in 2008 to 84.2% in 2019 and had low susceptibility rates to all other antibiotics tested. <b>Conclusions</b>: This study reveals high carbapenem resistance among <i>K. pneumoniae</i> and <i>A. baumannii</i> in Tunisia. <i>A. baumannii</i> shows alarming multidrug resistance that requires urgent control measures.
ISSN:2079-6382

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