Epidemiology and Pattern of Resistance of Gram-Negative Bacteria Isolated from Blood Samples in Hospitalized Patients: A Single Center Retrospective Analysis from Southern Italy
Paola Di Carlo,
Nicola Serra,
Sofia Lo Sauro,
Vincenza Maria Carelli,
Maurizio Giarratana,
Juan Camilo Signorello,
Alessandro Lucchesi,
Giuseppe Manta,
Maria Santa Napolitano,
Teresa Rea,
Antonio Cascio,
Consolato Maria Sergi,
Anna Giammanco,
Teresa Fasciana
Affiliations
Paola Di Carlo
Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, Italy
Nicola Serra
Department of Public Health, University Federico II of Naples, 80131 Napoli, Italy
Sofia Lo Sauro
Emergency Unit, Umberto I Hospital, 94100 Enna, Italy
Vincenza Maria Carelli
Microbiology Unit, Sant’Elia Hospital, 93100 Caltanissetta, Italy
Maurizio Giarratana
Microbiology Unit, Sant’Elia Hospital, 93100 Caltanissetta, Italy
Juan Camilo Signorello
Hypatia School of Medicine (UNIPA-Caltanissetta), University of Palermo, 90127 Palermo, Italy
Alessandro Lucchesi
Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy
Giuseppe Manta
Intensive Cure Unit (ICU), Sant’Elia Hospital, 93100 Caltanissetta, Italy
Maria Santa Napolitano
Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, Italy
Teresa Rea
Department of Public Health, University Federico II of Naples, 80131 Napoli, Italy
Antonio Cascio
Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, Italy
Consolato Maria Sergi
Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1, Canada
Anna Giammanco
Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, Italy
Teresa Fasciana
Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, 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.
