ANTIBIOTIC RESISTANCE IN COMMUNITY-ACQUIRED PNEUMONIA. A ROMANIAN PERSPECTIVE
IONUȚ EMILIAN BLEJAN 1#, CAMELIA CRISTINA DIACONU 2#, ANDREEA LETIȚIA ARSENE 1, DENISA IOANA UDEANU 1#, MANUELA GHICA 1*, DOINA DRĂGĂNESCU 1, GEORGE TRAIAN ALEXANDRU BURCEA DRAGOMIROIU 1, MIHAELA RĂDULESCU 3, HELENA C. MALTEZOU 4, ARISTIDES M. TSATSAKIS 5, MARIA PAPASAVVA 6, NIKOLAOS DRAKOULIS 6, DANIELA ELENA POPA 1
1“Carol Davila” University of Medicine and Pharmacy, Faculty of Pharmacy, Bucharest, Romania
2“Carol Davila” University of Medicine and Pharmacy, Clinical Emergency Hospital of Bucharest, Romania
3University of Economic Studies, Bucharest, Romania
4National Public Health Organization, 15123, Athens, Greece
5University of Crete, Medical School, Department of Toxicology and Forensic Sciences, 74100, Rethymno, Greece
6Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15771, Zografou, Greece
*corresponding author: manuela.ghica@umfcd.ro
#Authors with equal contribution.


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Abstract:
Community-acquired pneumonia (CAP) is one of the most common communicable diseases with a high mortality rate worldwide. Treatment is administered empirically based on clinical symptoms and the most commonly incriminated microorganisms in lower respiratory infections responsible for CAP. This study aimed to identify microorganisms responsible for CAP in patients hospitalized in an Emergency Hospital in Bucharest, Romania; to assess the impact of patients’ comorbidities and age on the survival level and to establish the degree of antimicrobial resistance of the most important isolated species. A total of 170 patients diagnosed with CAP from December 2017 through December 2018 were studied. Statistical analyses were performed considering the following data: survival rate, comorbidities, initiated pharmacotherapy, antibiogram results in case of refractory treatments. The overall survival rate was 36% among patients. Cardiovascular disease was incriminated as the highest risk factor. Concerning refractory antibiotic treatment, the microbiological results revealed that the most common bacterial strains detected were Klebsiella sp., Acinetobacter baumanii, S. aureus, E. coli and Pseudomonas, with high multiple antibiotic resistance (MAR) index. The results point out a real concern for patients with refractory CAP due to high antimicrobial resistance to the administered antibiotics in Romania.






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