This study systematically analyzed the prevalence and antimicrobial resistance dynamics of respiratory pathogens at the University of Rome Tor Vergata Hospital in Italy between 2018 and 2023, revealing rising trends of multidrug-resistant strains such as A. baumannii and K. pneumoniae, while emphasizing the need for attention to antifungal resistance in non-albicans Candida (NAC) species.
Literature Overview
This article, 'Time Trends in Prevalence and Antimicrobial Resistance of Respiratory Pathogens in a Tertiary Hospital in Rome, Italy: A Retrospective Analysis (2018–2023)', published in the Antibiotics journal, reviews and summarizes the epidemiological changes of respiratory pathogens and their evolving resistance to antimicrobial agents. Based on WHOnet 2025 software and EUCAST 2025 standards, the study analyzed over 54,000 microbe/drug associations, primarily from hospitalized patients. It reveals pathogen dynamics and provides critical references for clinical empirical treatment and infection control strategies.
Background Knowledge
Respiratory infections are common clinical challenges in global healthcare systems, particularly in elderly, chronic disease, and immunosuppressed populations. Antimicrobial resistance (AMR) has emerged as a global health threat, especially evident in multidrug-resistant bacteria such as A. baumannii and K. pneumoniae. These pathogens evade antibiotic effects through multiple mechanisms (e.g., β-lactamase production, biofilm formation), leading to treatment failure and increased mortality. Additionally, fungal species such as Candida albicans and non-albicans Candida (NAC) are increasingly significant respiratory pathogens, particularly in immunocompromised patients. This long-term retrospective analysis provides evidence-based support for hospital antimicrobial stewardship, public health policy formulation, and empirical treatment decisions, offering practical guidance for clinical practice.
Research Methods and Experiments
This study employed a retrospective observational design, collecting respiratory microbial isolate data from 6,953 patients at the University of Rome Tor Vergata Hospital between 2018 and 2023. Data were analyzed using WHOnet 2025 software, with antimicrobial susceptibility interpreted by EUCAST 2025 standards. The research evaluated pathogen prevalence, resistance rates, and temporal trends through Pearson correlation coefficients and linear regression models.
Key Conclusions and Perspectives
Research Significance and Prospects
This study provides real-world data support for hospital infection control and antimicrobial stewardship, highlighting clinical challenges posed by dynamic resistance patterns in respiratory pathogens. Future research should integrate clinical data with molecular mechanism analyses to explore transmission routes of resistance genes and host factors influencing resistance development. Enhanced environmental fungal monitoring is also recommended to address potential increases in antifungal resistance.
Conclusion
This study systematically analyzed the prevalence and antimicrobial resistance trends of respiratory pathogens at the University of Rome Tor Vergata Hospital between 2018 and 2023. Findings indicate A. baumannii and K. pneumoniae dominate bacterial respiratory pathogens with high multidrug resistance. Fungal infections showed increasing prevalence, particularly C. albicans, while non-albicans Candida strains demonstrated variable antifungal resistance. These results emphasize the necessity for dynamic adjustments in empirical antimicrobial therapy based on local resistance data, alongside strengthened antimicrobial stewardship, environmental disinfection, and infection control measures to address evolving resistance challenges. The study also advocates for future molecular epidemiology and resistance gene transmission research to support precision infection prevention and personalized treatment strategies.
