Healthcare-Associated Laboratory-Confirmed Bloodstream Infections—Species Diversity and Resistance Mechanisms, a Four-Year Retrospective Laboratory-Based Study in the South of Poland

Abstract

Introduction: Regardless of the country, advancements in medical care and infection prevention and control of bloodstream infections (BSIs) are an enormous burden of modern medicine. Objectives: The aim of our study was to describe the epidemiology and drug-resistance of laboratory-confirmed BSI (LC-BSIs) among adult patients of 16 hospitals in the south of Poland. Patients and methods: Data on 4218 LC-BSIs were collected between 2016–2019. The identification of the strains was performed using MALDI-TOF. Resistance mechanisms were investigated according to European Committee on Antimicrobial Susceptibility Testing, EUCAST recommendations. Results: Blood cultures were collected from 8899 patients, and LC-BSIs were confirmed in 47.4%. The prevalence of Gram-positive bacteria was 70.9%, Gram-negative 27.8% and yeast 1.4%. The most frequently isolated genus was Staphylococcus (50% of all LC-BSIs), with a domination of coagulase-negative staphylococci, while Escherichia coli (13.7%) was the most frequent Gram-negative bacterium. Over 4 years, 108 (2.6%) bacteria were isolated only once, including species from the human microbiota as well as environmental and zoonotic microorganisms. The highest methicillin resistant Staphylococcus aureus (MRSA) prevalence was in intensive care units (ICUs) (55.6%) but S. aureus with resistance to macrolides, lincosamides and streptogramins B (MLSB) in surgery was 66.7%. The highest prevalence of E. faecalis with a high-level aminoglycoside resistance (HLAR) mechanism was in ICUs, (84.6%), while E. faecium-HLAR in surgery was 83.3%. All cocci were fully glycopeptide-sensitive. Carbapenem-resistant Gram-negative bacilli were detected only in non-fermentative bacilli group, with prevalence 70% and more. Conclusions: The BSI microbiology in Polish hospitals was similar to those reported in other studies, but the prevalence of MRSA and enterococci-HLAR was higher than expected, as was the prevalence of carbapenem-resistant non-fermentative bacilli. Modern diagnostic techniques, such as MALDI-TOF, guarantee reliable diagnosis.

Epidemiology of Bloodstream Infections and Antimicrobial Susceptibility Pattern in ICU and Non-ICU Wards: A Four-Year Retrospective Study in Isfahan, Iran

“…[ 21 ] Chmielarczyk et al . [ 22 ] reported 279 (76.9%) from 363 patients admitted to ICU, 382 (68.6%) from 557 patients in surgical units, and 3557 (44.6%) from 7979 patients in other units had BSIs. Also, the prevalence of BSI was 17.2% in Rome, Italy.…”

Current viewpoint on the epidemiology of nonfermenting Gram-negative bacterial strains

“…Infections by NFGNB occur in the presence of several risk factors and, predominantly, in hospitalized patients. The risk factors for infection by NFGNB, include, among other, malignancy, immunosuppression, presence of intravascular devices and drain tubes, prolonged antibiotic use, lengthy hospitalization, older age, and presence of chronic respiratory disease or of other comorbidities [41,47,48 ▪▪ ]. It is noteworthy that Elizabethkingia spp.…”

Sulfa drugs–based Norbornenyl imides and reductive Heck reactions: Synthesis and antimicrobial screening

“…For example, Chmielarczyk et al reported that M. luteus , S. aureus , E. facealis , Salmonella spp, E. coli , and C. albicans were isolated from bloodstream infections more than ten times between 2016 and 2019 in their 4‐year laboratory‐based study in the south of Poland. [ 19 ] Apart from these pathogenic microorganisms, there are also cases caused by actinobacteria, which are a wide range of Gram‐positive filamentous bacteria and also a crucial soil component.…”