Ecology of Bloodstream Infections and Temporal Trends of Their Antibiograms with Respect to Source and Duration of Incubation: A 5-Year Retrospective Observational Analysis

Bacteriological profile and antibiotic sensitivity pattern of bloodstream infections from a teaching institution in Eastern Uttar Pradesh, North India

Introduction

Bloodstream infections (BSIs), encompassing both self-limiting bacteremia and potentially fatal septicaemia, make up the majority of healthcare-associated ailments worldwide. The organisms encountered are mostly multidrug-resistant (MDROs), leading to increased hospital stays. Our study aims to collect data about blood culture isolates from a medical college in eastern Uttar Pradesh, India.

Materials and Methods

A retrospective analysis of blood culture isolates obtained at our laboratory for ten months from patients with clinical suspicion of sepsis or infection with the possibility of haematogenous spread was done. We only considered consecutive and patient-specific, non-duplicate isolates. Blood samples were initially incubated in BacT/ALERT® and then manually processed once they flagged positive.

Results

A total of 1,033 blood samples were received, of which 217 (21%) showed the growth of a pathogenic organism. The positivity rate varied significantly across different age groups, locations, and departments (P value < 0.001). It was higher among in-patients, those with central venous access, and patients with diabetes mellitus (DM). Staphylococcus aureus [n = 105, 48.38%] was isolated most commonly, with a high prevalence of methicillin resistance (83%). Enterococcus demonstrated a high degree of resistance. MDROs accounted for 68% of the detected Gram-negatives.

Discussion

This study comprehensively analyses blood culture results from a diverse group of patients and emphasizes the association between risk factors and positive blood cultures. Gram-positive and Gram-negative isolates demonstrated low sensitivity to common antibiotics, urging vigilant monitoring and specific therapy.

Conclusion

Our study reveals important insights guiding clinical practices, antimicrobial stewardship, and infection control strategies.

Epidemiology and Pattern of Resistance of Gram-Negative Bacteria Isolated from Blood Samples in Hospitalized Patients: A Single Center Retrospective Analysis from Southern Italy

BACKGROUND

Blood culturing remains the mainstream tool to inform an appropriate treatment in hospital-acquired bloodstream infections and to diagnose any bacteremia.

METHODS

A retrospective investigation on the prevalence of Gram-negative bacteria (GNB) and their resistance in hospitalized patients by age, sex, and units from blood cultures (BCs) was conducted from January 2018 to April 2020 at Sant'Elia hospital, Caltanissetta, southern Italy. We divided the patient age range into four equal intervals.

RESULTS

Multivariate demographic and microbiological variables did not show an association between bacteria distributions and gender and age. The distribution by units showed a higher prevalence of Klebsiella pneumoniae and Acinetobacter baumannii in the intensive care unit (ICU) and Escherichia coli in the non-intensive care units (non-ICUs). The analysis of antibiotic resistance showed that E. coli was susceptible to a large class of antibiotics such as carbapenem and trimethoprim-sulfamethoxazole. K. pneumoniae showed a significant susceptibility to colistin, tigecycline, and trimethoprim-sulfamethoxazole. From the survival analysis, patients with E. coli had a higher survival rate.

CONCLUSIONS

The authors stress the importance of the implementation of large community-level programs to prevent E. coli bacteremia. K. pneumoniae and E. coli susceptibility patterns to antibiotics, including in the prescription patterns of general practitioners, suggest that the local surveillance and implementation of educational programs remain essential measures to slow down the spread of resistance and, consequently, increase the antibiotic lifespan.