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. 2020 Nov 28;9(12):851.
doi: 10.3390/antibiotics9120851.

Sepsis-A Retrospective Cohort Study of Bloodstream Infections

Biagio Santella  1 , Veronica Folliero  2 , Gerarda Maria Pirofalo  3 , Enrica Serretiello  1 , Carla Zannella  2 , Giuseppina Moccia  4 , Emanuela Santoro  4 , Giuseppina Sanna  5 , Oriana Motta  4 , Francesco De Caro  3   4 , Pasquale Pagliano  4 , Mario Capunzo  3   5 , Massimiliano Galdiero  1   2 , Giovanni Boccia  3   4 , Gianluigi Franci  3   4
Affiliations

Sepsis-A Retrospective Cohort Study of Bloodstream Infections

Biagio Santella et al. Antibiotics (Basel). .

Abstract

Bloodstream infections (BSIs) are among the leading causes of morbidity and mortality worldwide, among infectious diseases. Local knowledge of the main bacteria involved in BSIs and their associated antibiotic susceptibility patterns is essential to rationalize the empiric antimicrobial therapy. The aim of this study was to define the incidence of infection and evaluate the antimicrobial resistance profile of the main pathogens involved in BSIs. This study enrolled patients of all ages and both sexes admitted to the University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy between January 2015 to December 2019. Bacterial identification and antibiotic susceptibility testing were performed with Vitek 2. A number of 3.949 positive blood cultures were included out of 24,694 total blood cultures from 2015 to 2019. Coagulase-negative staphylococci (CoNS) were identified as the main bacteria that caused BSI (17.4%), followed by Staphylococcus aureus (12.3%), Escherichia coli (10.9%), and Klebsiella pneumoniae (9.4%). Gram-positive bacteria were highly resistant to Penicillin G and Oxacillin, while Gram-negative strains to Ciprofloxacin, Cefotaxime, Ceftazidime, and Amoxicillin-clavulanate. High susceptibility to Vancomycin, Linezolid, and Daptomycin was observed among Gram-positive strains. Fosfomycin showed the best performance to treatment Gram-negative BSIs. Our study found an increase in resistance to the latest generation of antibiotics over the years. This suggests an urgent need to improve antimicrobial management programs to optimize empirical therapy in BSI.

Keywords: antimicrobial sensitivity; blood culture; bloodstream infections; empiric therapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Incidence of bloodstream infection (BSI) cases by year of study, expressed as a percentage relative to the total number of positive cases out of the total number of cases present per year of study.
Figure 2
Figure 2
Incidence of BSI cases by study year associated with the sex of the patients involved.
Figure 3
Figure 3
Distribution of positive cases by age group.
Figure 4
Figure 4
Trend in percentage of batteries caused by the most frequent isolates.
See this image and copyright information in PMC

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