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

Abstract

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.

Biocide Susceptibility and Antimicrobial Resistance of Escherichia coli Isolated from Swine Feces, Pork Meat and Humans in Germany

“…Overall, 64% of the tested isolates (57% from healthcare settings and 43% from swine) were resistant to three or more classes of antimicrobials and were thereby classified as MDR. MDR E. coli have been widely reported in livestock [15,38,39], food [40] and nosocomial infections [41][42][43][44][45]. As expected, the highest resistance rates to most of the substances, including AMP, SME, TRI, CIP, NAL and AZI, were found in isolates from hospital patients.…”

Bacteriological Profile and Antimicrobial Susceptibility Patterns of Gram-Negative Bloodstream Infection and Risk Factors Associated with Mortality and Drug Resistance: A Retrospective Study from Shanxi, China

“…[28][29][30][31][32] While an Italian study showed that the most frequently isolated pathogens were K. pneumoniae (45.3%), followed by E. coli (15.4%). 33 This difference in primary bacteria might be associated with geographic area. As a study reported that K. pneumoniae was endemic in European countries bordering the Mediterranean Sea.…”

Microbial profile in bile from pancreatic and extra-pancreatic biliary tract cancer

“…Escherichia coli , Klebsiella spp, and Pseudomonas spp isolated in our bile samples are known as Multi Drug-Resistant (MDR) pathogens responsible for hospital bloodstream infection in the Mediterranean basin area [ 52 , 53 ].…”