Factors Associated with Extended-Spectrum β-Lactamases and Carbapenem-Resistant Bloodstream Infections: A Five-Year Retrospective Study.

is one of the leading causes of nosocomial infections. It has been estimated that nosocomial infection by comprises 3-8% of all nosocomial infections. bloodstream infections (BSIs) occur worldwide with varying mortality. Resistant strains, like those producing extended-spectrum beta-lactamases (ESBL) and carbapenemases, are becoming increasingly common, especially in hospital settings, posing therapeutic challenges. In this article, we aimed to study the epidemiology and risk factors of BSIs due to resistant strains in the period 1 January 2014-31 December 2018 at the Nicosia General Hospital, the largest tertiary hospital in Cyprus. Data on demographics, co-morbidities, prior hospitalization, prior intensive care unit (ICU) admission, previous antimicrobial use, nosocomial acquisition of the infection, the presence of a prosthetic device or surgery, and the primary site of infection were retrospectively recorded. Associations between the detection of ESBL BSIs and factors/covariates were examined using logistic regression. This study involved 175 patients with BSI caused by . Of these, 61 BSIs were caused by ESBL strains, 101 by non-ESBL, and 13 by carbapenem-resistant (CR) strains. In univariable analyses, age, sex, heart disease, antimicrobial use during current admission, previous hospitalization (ward or ICU), and primary BSI were associated with the presence of an ESBL strain. Antibiotic use during current admission and heart disease remained statistically significantly associated with ESBL BSI in multivariable models. Antibiotic use during current admission, respiratory infection, and a recent history of surgery were more prevalent among CR BSI patients than among non-CR BSI patients. Our study showed that recent antimicrobial use and heart disease were associated with BSI due to ESBL-producing . This finding could inform clinical practice in hospital settings.