Bloodstream infections caused by multidrug-resistant gram-negative bacteria: epidemiological, clinical and microbiological features

• Published in: BMC infectious diseases Vol. 19; no. 1; p. 609
• Main Authors: Leal, Helena Ferreira, Azevedo, Jailton, Silva, Giulyana Evelyn Oliveira, Amorim, Angelica Maria Lima, de Roma, Larissa Rangel Cabral, Arraes, Ana Carolina Palmeira, Gouveia, Edilane Lins, Reis, Mitermayer Galvão, Mendes, Ana Verena, de Oliveira Silva, Marcio, Barberino, Maria Goreth, Martins, Ianick Souto, Reis, Joice Neves
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.07.2019; BioMed Central; BMC
• Subjects: Antibiotic resistance; Bacteremia; Bacteria; Causes of; Complications and side effects; Diagnosis; Drug resistance; Enzymes; Epidemiology; Genes; Genetic research; Gram-negative bacteria; Infection; Liver; Liver diseases; Medical personnel; Microbial drug resistance; Microbiology; Morbidity; Mortality; Oxalic acid; Pathogenic microorganisms; Physiological aspects; Pneumonia; Sepsis; Brazil; Bacteremia; Antibiotic resistance; Gram-negative bacteria
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-4265-z

Bloodstream infections (BSI) are associated with high morbidity and mortality. This scenario worsens with the emergence of drug-resistant pathogens, resulting in infections which are difficult to treat or even untreatable with conventional antimicrobials. The aim of this study is to describe the epidemiological aspects of BSI caused by multiresistant gram-negative bacilli (MDR-GNB). We conducted a laboratory-based surveillance for gram-negative bacteremia over a 1-year period. The bacterial isolates were identified by MALDI-TOF/MS and the antimicrobial susceptibility testing was performed by VITEK®2. Resistance genes were identified through PCR assays. Of the 143 patients, 28.7% had infections caused by MDR-GNB. The risk factors for MDR bacteremia were male sex, age ≥ 60, previous antimicrobial use, liver disease and bacteremia caused by K. pneumoniae. K. pneumoniae was the most frequently observed causative agent and had the highest resistance level. Regarding the resistance determinants, SHV, TEM, OXA-1-like and CTX-M-gp1 were predominant enzymatic variants, whereas CTX-M-gp9, CTX-M-gp2, KPC, VIM, GES, OXA-48-like, NDM and OXA-23-like were considered emerging enzymes. Here we demonstrate that clinically relevant antibiotic resistance genes are prevalent in this setting. We hope our findings support the development of intervention measures by policy makers and healthcare professionals to face antibiotic resistance.