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

• Published in: International journal of environmental research and public health 2021-03, Vol.18 (5), p.2785
• Main Authors: Chmielarczyk, Agnieszka, Pomorska-Wesołowska, Monika, Romaniszyn, Dorota, Wójkowska-Mach, Jadwiga
• Format: Article
• Language: English
• Subjects: Adult; Aminoglycosides; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antiinfectives and antibacterials; Bacilli; Bacteremia - epidemiology; Bacteria; Coagulase; Cross Infection - drug therapy; Cross Infection - epidemiology; Delivery of Health Care; Drug resistance; Epidemiology; Glycopeptides; Gram-negative bacilli; Gram-positive bacteria; Hospitals; Humans; Infections; Intensive care; Intensive care units; Laboratories; Lincosamides; Methicillin; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Microbiology; Microbiota; Microorganisms; Mortality; Patients; Poland - epidemiology; Public health; Retrospective Studies; Sepsis; Species diversity; Staphylococcus aureus; Streptogramins; Surgery; Yeasts
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph18052785

Regardless of the country, advancements in medical care and infection prevention and control of bloodstream infections (BSIs) are an enormous burden of modern medicine. 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. 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. 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 (50% of all LC-BSIs), with a domination of coagulase-negative staphylococci, while (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 (MRSA) prevalence was in intensive care units (ICUs) (55.6%) but with resistance to macrolides, lincosamides and streptogramins B (MLS ) in surgery was 66.7%. The highest prevalence of with a high-level aminoglycoside resistance (HLAR) mechanism was in ICUs, (84.6%), while -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. 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.