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Increasing Incidence and Antimicrobial Resistance Amongst
Nosocomial Isolates in Latvia Poses a Significant Public Health
Challenge
Nityanand Jain a,b, Aigars Reinis a,b, Dagnija Straupmane a, and Mihails Dolgusevs b
a Joint Laboratory of Microbiology, Pauls Stradins Clinical University Hospital, Riga, Latvia
b Faculty of medicine, Riga Stradins University, Riga, Latvia
Objectives
Nosocomial infections or healthcare-associated infections (HAIs) are defined as hospital-acquired
infections in patients who previously were free from infection at the time of admission to the hospital.
They are associated with increased complications, costs, and prolonged hospitalization durations.
Hence, it is essential to observe and manage the situation as it evolves. To achieve this, constant
surveillance, and monitoring of the trends of isolation, antimicrobial properties etc., of the nosocomial
infections should be done. Therefore, in the present study we investigated the incidence of
antimicrobial resistant strains of most important nosocomial pathogens in a hospital in Latvia from
2020-2021.
Methods
The data regarding antimicrobial resistance, patient sample of isolation, and department of isolation
were obtained from the Joint Laboratory digital records (anonymized before processing). Antimicrobial
resistance was checked using disk diffusion, and broth dilution based on latest EUCAST guidelines.
The data was compiled and analyzed using SPSS version 27.0
Results
There was a significant increase in the isolation of Carbapenem-resistant Enterobacteria species
between 2020 and 2021 (p < 0.05), especially K. pneumoniae, E.coli, and C. freundii. Most samples were
isolated from urine and faecal matter samples amongst patients admitted to intensive care unit. Similar
observations were made for Vancomycin-resistant Enterococcus, with E. faecium being the most
commonly isolated species from urine and faecal matter samples. Most of the Vancomycin-resistant
Enterococcus infections were reported in Nephrology, Gastroenterology, and Intensive care units.
There was a decrease noted in the incidence of MRSA (Methicillin-resistant Staphylococcus aureus)
isolates between 2020 and 2021. Majority of the samples were isolated from bronchial wash and nasal
swab. Vascular Surgery and Intensive care units were the two departments with highest caseload of
MRSA infections in the hospital. Finally, amongst the extended spectrum beta-lactamase (ESBL)
Enterobacterales, E. coli, P. mirabilis, and K. pneumoniae were most isolated pathogens. They were
commonly isolated from urine samples from patients admitted to the intensive care unit and
gastroenterology departments.
Conclusions
Vigilant monitoring and implementation of proper precautions and biosafety protocols is essential to
reduce the incidence of antimicrobial resistant nosocomial strains.