This study systematically analyzed the prevalence and resistance patterns of respiratory pathogens at the University of Rome Tor Vergata Hospital between 2018 and 2023, revealing increasing trends of multidrug-resistant strains such as A. baumannii and K. pneumoniae, while highlighting 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 epidemiological shifts and antimicrobial resistance evolution in respiratory pathogens. Utilizing WHOnet 2025 software and EUCAST 2025 standards, the study analyzed over 54,000 microbe/drug association records primarily from hospitalized patients. It documents pathogen dynamics to inform empirical clinical treatment and infection control strategies.
Background Knowledge
Respiratory infections represent common clinical challenges globally, particularly in elderly, chronic disease, and immunosuppressed populations where drug resistance frequently emerges. Antimicrobial Resistance (AMR) has become a critical global health threat, especially evident in multidrug-resistant bacteria like A. baumannii and K. pneumoniae. These pathogens evade antibiotic effects through multiple mechanisms (e.g., β-lactamases, biofilm formation), leading to treatment failures and increased mortality. Additionally, fungal species such as Candida albicans and non-albicans Candida (NAC) are increasingly significant respiratory pathogens, particularly among immunosuppressed patients. This long-term retrospective analysis provides evidence-based support for hospital antimicrobial stewardship programs, public health policy development, and empirical treatment selection, offering vital guidance for clinical practice.
Research Methods and Experiments
This retrospective observational study collected respiratory microbial isolate data from patients treated at the University of Rome Tor Vergata Hospital between 2018 and 2023 (n=6,953). Data were analyzed using WHOnet 2025 software with antimicrobial susceptibility interpreted by EUCAST 2025 standards. The study evaluated pathogen prevalence, antimicrobial resistance rates, and temporal trends through statistical analysis using Pearson correlation coefficients and linear regression models.
Key Conclusions and Perspectives
Research Significance and Prospects
The findings provide real-world data support for hospital infection control and antimicrobial stewardship programs, emphasizing clinical challenges posed by evolving resistance patterns in respiratory pathogens. Future research should integrate clinical data with molecular mechanisms to explore transmission routes of resistance genes and host factors influencing antimicrobial resistance. Environmental fungal surveillance should also be strengthened to address potential increases in antifungal resistance.
Conclusion
This study systematically analyzed prevalence and antimicrobial resistance trends of respiratory pathogens at the University of Rome Tor Vergata Hospital between 2018 and 2023. Findings revealed dominant bacterial pathogens A. baumannii and K. pneumoniae with high multidrug resistance. Fungal infection proportions increased significantly, particularly C. albicans prevalence, while non-albicans Candida strains demonstrated variable antifungal resistance. These results emphasize the necessity for dynamically adjusted empirical treatment strategies based on local resistance data, combined with strengthened antimicrobial stewardship, environmental disinfection, and infection control measures to address growing resistance challenges. The study further advocates for enhanced molecular epidemiology research and resistant gene transmission tracking to support precision infection prevention and personalized treatment protocols.
