{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:23:18Z","timestamp":1792606998519,"version":"4.5.0"},"reference-count":34,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,11]],"date-time":"2022-09-11T00:00:00Z","timestamp":1662854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Antimicrobial resistance represents a serious problem, and it may be life-threatening in the case of severe hospital-acquired infections (HAI). Antibiotic abuse and multidrug resistance (MDR) have significantly increased this burden in the last decades. The aim of this study was to investigate the distribution and susceptibility rates of five selected bacterial species (E. coli, K. pneumoniae, P. aeruginosa, S. aureus and E. faecium) in two healthcare settings located in the Apulia region (Italy). Materials and Methods: Setting n.1 was a university hospital and setting n.2 was a research institute working on oncological patients. All the enrolled patients were diagnosed for bacterial HAI. The observation period was between August and September 2021. Clinical samples were obtained from several biological sources, in different hospital wards. Bacterial identification and susceptibility were tested by using the software VITEC 2 Single system. Results: In this study, a higher incidence of multi-drug-resistant K. pneumoniae was reported (42,2% in setting n.1 and 50% in setting n.2), with respect to the Italian 2019 statistics report (30.3%). All the isolates of E. faecium and S. aureus were susceptible to linezolid. All the bacterial isolates of P. aeruginosa and most of K. pneumoniae were susceptible to ceftazidime\u2013avibactam. Amikacin and nitrofurantoin represented a good option for treating E. coli infections. Multidrug-resistant (MDR) P. aeruginosa, methicillin-resistant S. aureus (MRSA) and vancomycin-resistantE. faecium (VRE) had a lower incidence in the clinical setting, with respect to E. coli and K. pneumoniae. Conclusions: The data obtained in this study can support clinicians towards a rational and safe use of antibiotics for treating the infections caused by these resistant strains, to enhance the overall efficacy of the current antibiotic protocols used in the main healthcare environments.<\/jats:p>","DOI":"10.3390\/medicina58091257","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T01:44:03Z","timestamp":1663033443000},"page":"1257","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Antibiotic Abuse and Antimicrobial Resistance in Hospital Environment: A Retrospective Observational Comparative Study"],"prefix":"10.3390","volume":"58","author":[{"given":"Patrizia","family":"Nardulli","sequence":"first","affiliation":[{"name":"IRCCS Istituto Tumori \u201cG. Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Gustafsson","family":"Hall","sequence":"additional","affiliation":[{"name":"Visby Hospital, Section of Clinical Microbiology and Infectious Diseases, Department of Medical Sciences, 62156 Visby, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Quarta","sequence":"additional","affiliation":[{"name":"DLV System s.r.l., Research Section, Viale della Resistenza, 19, 87036 Quattromiglia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7834-5864","authenticated-orcid":false,"given":"Giovanni","family":"Fruscio","sequence":"additional","affiliation":[{"name":"Energent s.p.a., Research Section, Via Cristoforo Colombo, 112, 00154 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariarita","family":"Laforgia","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Tumori \u201cG. Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito M.","family":"Garrisi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Tumori \u201cG. Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Tecnologica s.r.l., Research Section, 88900 Crotone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2717-2489","authenticated-orcid":false,"given":"Salvatore","family":"Scacco","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari \u201cAldo Moro\u201d, 70100 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4816-4456","authenticated-orcid":false,"given":"Danila","family":"De Vito","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Bari \u201cAldo Moro\u201d, 70100 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1159\/000141500","article-title":"Nosocomial infections in a medical-surgical intensive care unit","volume":"17","author":"Aly","year":"2008","journal-title":"Med. Princ. and Pract."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Fusco, A., Dicuonzo, G., Dell\u2019Atti, V., and Tatullo, M. (2020). Blockchain in Healthcare: Insights on COVID-19. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17197167"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Cond\u00f2, R., Mampieri, G., Pasquantonio, G., Giancotti, A., Pirelli, P., Cataldi, M.E., La Rocca, S., Leggeri, A., Notargiacomo, A., and Maiolo, L. (2021). In vitro evaluation of structural factors favouring bacterial adhesion on orthodontic adhesive resins. Materials, 14.","DOI":"10.20944\/preprints202103.0322.v1"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1007\/s001340050713","article-title":"Nosocomial infections: Prospective survey of incidence in five French intensive care units","volume":"24","author":"Legras","year":"1998","journal-title":"Intensive Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"609459","DOI":"10.3389\/fmicb.2021.609459","article-title":"Futuristic non-antibiotic therapies to combat antibiotic resistance: A review","volume":"12","author":"Kumar","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Tatullo, M., Codispoti, B., Paduano, F., Nuzzolese, M., and Makeeva, I. (2019). Strategic Tools in Regenerative and Translational Dentistry. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20081879"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1089\/apc.2006.20.606","article-title":"Amoebic hepatic abscesses in an HIV-positive patient","volume":"20","author":"Brindicci","year":"2006","journal-title":"AIDS Patient Care STDs"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1053\/jinf.2002.1036","article-title":"Chlamydia pneumoniae in community acquired pneumonia: Seven years of experience","volume":"45","author":"Monno","year":"2002","journal-title":"J. Infect."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2066","DOI":"10.3389\/fmicb.2018.02066","article-title":"Antibiotics, resistome and resistance mechanisms: A bacterial perspective","volume":"9","author":"Sultan","year":"2018","journal-title":"Front. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"34","DOI":"10.3389\/fmicb.2015.00034","article-title":"Mechanisms of antibiotic resistance","volume":"6","author":"Lin","year":"2015","journal-title":"Front. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1007\/s00277-018-3575-3","article-title":"Vascular density and inflammatory infiltrate in primary oral squamous cell carcinoma and after allogeneic hematopoietic stem cell transplantation","volume":"98","author":"Tamma","year":"2019","journal-title":"Ann. Hematol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Tatullo, M., and Gandolfi, M.G. (2021). Cells: Are They (Still) Essential for Dental Regeneration?. Cells, 10.","DOI":"10.3390\/cells10030498"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/nrmicro3380","article-title":"Molecular mechanisms of antibiotic resistance","volume":"13","author":"Blair","year":"2015","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"91","DOI":"10.17305\/bjbms.2011.2588","article-title":"Antimicrobial resistance status and prevalence rates of extended spectrum beta-lactamase producers isolated from a mixed human population","volume":"11","author":"Afunwa","year":"2011","journal-title":"Bosn. J. Basic Med. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Limongelli, L., Cascardi, E., Capodiferro, S., Favia, G., Corsalini, M., Tempesta, A., and Maiorano, E. (2020). Multifocal Amelanotic Melanoma of the Hard Palate: A Challenging Case. Diagnostics, 10.","DOI":"10.3390\/diagnostics10060424"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Gardin, C., Bosco, G., Ferroni, L., Quartesan, S., Rizzato, A., Tatullo, M., and Zavan, B. (2020). Hyperbaric Oxygen Therapy Improves the Osteogenic and Vasculogenic Properties of Mesenchymal Stem Cells in the Presence of Inflammation In Vitro. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21041452"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Cond\u00f2, R., Mampieri, G., Giancotti, A., Cerroni, L., Pasquantonio, G., Divizia, A., Convertino, A., Mecheri, B., and Maiolo, L. (2021). SEM characterization and ageing analysis on two generation of invisible aligners. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01676-z"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"86","DOI":"10.17305\/bjbms.2018.3826","article-title":"Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China","volume":"19","author":"Wang","year":"2019","journal-title":"Bosn. J. Basic Med. Sci."},{"key":"ref_19","first-page":"162","article-title":"Assessment of carbapenem susceptibility and multidrug-resistance in Pseudomonas aeruginosa burn isolates in Tehran","volume":"6","author":"Moazami","year":"2013","journal-title":"Jundishapur J. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Tatullo, M., Zavan, B., Genovese, F., Codispoti, B., Makeeva, I., Rengo, S., Fortunato, L., and Spagnuolo, G. (2019). Borophene Is a Promising 2D Allotropic Material for Biomedical Devices. Appl. Sci., 9.","DOI":"10.3390\/app9173446"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S1473-3099(08)70041-0","article-title":"Extended-spectrum \u03b2-lactamase-producing Enterobacteriaceae: An emerging public-health concern","volume":"8","author":"Pitout","year":"2008","journal-title":"Lancet Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1179\/1465313314Y.0000000117","article-title":"Lower incisor extraction treatment with the Invisalign\u00ae technique: Three case reports","volume":"42","author":"Giancotti","year":"2015","journal-title":"J. Orthod."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1126\/science.1159483","article-title":"Antibiotics and antibiotic resistance genes in natural environments","volume":"321","year":"2008","journal-title":"Science"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Cascardi, E., Cazzato, G., Daniele, A., Silvestris, E., Cormio, G., Di Vagno, G., Malvasi, A., Loizzi, V., Scacco, S., and Pinto, V. (2022). Association between Cervical Microbiota and HPV: Could This Be the Key to Complete Cervical Cancer Eradication?. Biology, 11.","DOI":"10.3390\/biology11081114"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Codispoti, B., Marrelli, M., Paduano, F., and Tatullo, M. (2018). NANOmetric BIO-Banked MSC-Derived Exosome (NANOBIOME) as a Novel Approach to Regenerative Medicine. J. Clin. Med., 7.","DOI":"10.3390\/jcm7100357"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1089\/mdr.2010.0132","article-title":"The CTX-M conundrum: Dissemination of plasmids and Escherichia coli clones","volume":"17","author":"Naseer","year":"2011","journal-title":"Microb. Drug Resist."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Tatullo, M., Genovese, F., Aiello, E., Amantea, M., Makeeva, I., Zavan, B., Rengo, S., and Fortunato, L. (2019). Phosphorene Is the New Graphene in Biomedical Applications. Materials, 12.","DOI":"10.3390\/ma12142301"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.ijmm.2013.02.008","article-title":"CTX-M-type \u03b2-lactamases: A successful story of antibiotic resistance","volume":"303","author":"Arena","year":"2013","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"298","DOI":"10.7326\/0003-4819-134-4-200102200-00014","article-title":"Antibiotic resistance in the intensive care unit","volume":"134","author":"Kollef","year":"2001","journal-title":"Ann. Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.7150\/ijms.27908","article-title":"About stem cell research in dentistry: Many doubts and too many pitfalls still affect the regenerative dentistry","volume":"15","author":"Tatullo","year":"2018","journal-title":"Int. J. Med. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Fern\u00e1ndez, H., Santos, H.M., Capelo, J.L., Fdez-Riverola, F., Glez-Pe\u00f1a, D., and Reboiro-Jato, M. (2015). Mass-Up: An all-in-one open software application for MALDI-TOF mass spectrometry knowledge discovery. BMC Bioinform., 16.","DOI":"10.1186\/s12859-015-0752-4"},{"key":"ref_32","unstructured":"Devlin, J., Chang, M.W., Lee, K., and Toutanova, K. (2018). Bert: Pre-training of deep bidirectional transformers for language understanding. arXiv."},{"key":"ref_33","unstructured":"He, K., Zhang, X., Ren, S., and Sun, J. (July, January 26). Deep residual learning for image recognition. Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition (CVPR), Las Vegas, NV, USA."},{"key":"ref_34","unstructured":"Oord, A.V. (2016, January 13\u201315). Wavenet: A generative model for raw audio. Proceedings of the 9th ISCA Workshop on Speech Synthesis Workshop (SSW 9), Sunnyvale, CA, USA."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/9\/1257\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:29:34Z","timestamp":1760142574000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/9\/1257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,11]]},"references-count":34,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["medicina58091257"],"URL":"https:\/\/doi.org\/10.3390\/medicina58091257","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,11]]}}}