Kłos M, Pomorska-Wesołowska M, Romaniszyn D, Wójkowska-Mach J, Chmielarczyk A
Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
Department of Microbiology, Analytical and Microbiological Laboratory, KORLAB, Ruda Slaska, Poland.
Int J Microbiol. 2021 Jan 16;2021:6687148. doi: 10.1155/2021/6687148. eCollection 2021.
Bloodstream infections (BSIs) are one of the most frequently observed hospital-acquired infections (HAIs). We sought to describe the epidemiology and drug resistance secondary BSIs in surgical patients and check for any correlation with the type of hospital ward.
This multicenter (13 hospitals in southern Poland) laboratory-based retrospective study evaluated adults diagnosed with BSI secondary to surgical site infection (SSI) hospitalized in 2015-2018; 121 strains were collected. The drug resistance was tested according to the EUCAST recommendations. Tests confirming the presence of extended-spectrum -lactamases (ESBLs) and resistance genes were carried out. The occurrence of possible clonal epidemics among strains was examined.
The prevalence of in secondary BSI was 12.1%; the most common strains were ( = 74, 61.2%) and spp. ( = 33, 27.2%). High resistance involved ampicillin and ampicillin/sulbactam (92, 8-100%), fluoroquinolones (48-73%), and most cephalosporins (29-50%). Carbapenems were the antimicrobials with the susceptibility at 98%. The prevalence of ESBL strains was 37.2% ( = 45). All the ESBL strains had gene, 26.7% had the gene, and 24.4% had gene. The diversity of strains was relatively high. Only 4 strains belonged to one clone.
What is particularly worrying is the high prevalence of in BSI, as well as the high resistance to antimicrobial agents often used in the empirical therapy. To improve the effectiveness of empirical treatment in surgical departments, we need to know the epidemiology of both surgical site infection and BSI, secondary to SSI. We were surprised to note high heterogeneity among strains, which was different from our previous experience.
血流感染（BSIs）是最常见的医院获得性感染（HAIs）之一。我们试图描述手术患者继发性血流感染的流行病学和耐药情况，并检查其与医院病房类型的相关性。
这项基于实验室的多中心研究（波兰南部13家医院）评估了2015 - 2018年因手术部位感染（SSI）继发血流感染而住院的成年患者；共收集了121株菌株。根据欧洲抗菌药物敏感性试验委员会（EUCAST）的建议进行耐药性测试。进行了确认超广谱β-内酰胺酶（ESBLs）和耐药基因存在的检测。检查了菌株中可能的克隆流行情况。
继发性血流感染中该菌的患病率为12.1%；最常见的菌株是[具体菌名未给出]（n = 74，61.2%）和[具体菌名未给出]属（n = 33，27.2%）。高耐药率涉及氨苄西林和氨苄西林/舒巴坦（92，8 - 100%）、氟喹诺酮类（48 - 73%）以及大多数头孢菌素（29 - 50%）。碳青霉烯类抗菌药物的敏感性为98%。ESBL菌株的患病率为37.2%（n = 45）。所有ESBL菌株都有[具体基因未给出]基因，26.7%有[具体基因未给出]基因，24.4%有[具体基因未给出]基因。菌株的多样性相对较高。只有4株属于一个克隆。
特别令人担忧的是血流感染中该菌的高患病率，以及对经验性治疗中常用抗菌药物的高耐药性。为提高外科科室经验性治疗的有效性，我们需要了解手术部位感染和继发于SSI的血流感染的流行病学情况。我们惊讶地注意到菌株之间存在高度异质性，这与我们之前的经验不同。
