A comparison of Multi Drug Resistant and Extended Drug Resistant bacteria in dermatological versus diabetes patients and how antibiotic overuse might cause medical malpractice

R. Furau, A. R. Popa, C. Precup, C. Furau, V. Toma, M. Dimitriu, D. G. Negru, E. D. Popovici, C. Marcean, C. F. Ifrim

Abstract: Antibiotherapy is one of the most successfully medical achievement against infections but its overuse creates the premises for the development of resistant multi-drug germs, which might be medical malpractice as long as there are other therapeutic approaches. Even topical antibiotics contribute to emergence of resistant bacteria. This study reflects antibiotic multidrug resistance (MDR) and extensively drug-resistant (XDR) of isolates found in dermatology and diabetes inpatients. During a five-years follow-up: there were 10,540 patients prevalent age category 60-69 years, infection rate 10.47%. and mortality rate 1.72% . MDR was present in 30% of cases. MDR of 42.03% in dermatology is ranking it of the fourth severity level after palliative (69.74%), ICUs (57.38%) and dialysis (50%) units. The chance (OR) to find MDR Gram-positive bacteria was 3 times higher for dermatological cases compared to others (OR 3.0256; 95% CI 1.802 to 5.0801; P <0.0001). MDR Escherichia coli in dermatology was double compared to diabetes (OR 2.7003, 95% CI 1.3392 to 5.4444, P = 0.0055) and so is the case of all Gram-negative germs in dermatology (OR 2.2502, 95% CI 1.5312 to 3.3068, P <0.0001). Surveillance of MDR and XDR ESKAPE germs showed that Klebsiella pneumoniae exhibits 11.32% MDR; all Acinetobacter strains were MDR; Acinetobacter baumannii was resistant to carbapenems and carbapenemase producer; Acinetobacter calcoaceticus was carbapenem resistant and carbapenemase producer in 66.66% of cases with one isolate resistant to glycylcicline, which defines it as XDR. Pseudomonas aeruginosa and Enterobacter spp MDR reached 28.22% and 25% respectively.
Keywords: MDR, XDR, dermatology, diabetes.