Antimicrobial Resistance in Bacilli Isolated from Bloodstream Infection in Surgical Patients of Polish Hospitals.

BACKGROUND AND AIMS

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.