Causative agents of bloodstream infections in two Croatian hospitals and their resistance mechanisms

Abstract

Blood samples were collected alongside with routine blood cultures (BC) from patients with suspected sepsis, to evaluate the prevalence of different causative agents in patients with bacteraemia. Among 667 blood samples, there were 122 positive BC (18%). Haemoglobin content, platelet number, and systolic blood pressure values were significantly lower in patients with positive BC, whereas serum lactate levels, CRP, creatinine and urea content were significantly higher in patients with positive BC. The rate of multidrug (MDR) or extensively drug resistant (XDR) bacteria was 24% (n = 29): Klebsiella pneumoniae (9), Pseudomonas aeruginosa (9), Acinetobacter baumannii (4), Escherichia coli (1), vancomycin resistant Enterococcus spp (VRE) (3), and methicillin-resistant Staphylococcus aureus MRSA (3). The dominant resistance mechanisms were the production of extended-spectrum β-lactamases, OXA-48 carbapenemase, and colistin resistance in K. pneumoniae, VIM metallo-β-lactamases in P. aeruginosa and OXA-23-like oxacillinases in A. baumannii. The study revealed high rate of MDR strains among positive BCs in Zagreb, Croatia.

Keywords:

• Multidrug-resistant bacteria
• Klebsiella pneumoniae
• Acinetobacter baumannii
• bloodstream infections
• extended-spectrum β-lactamases

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical permission

The project was approved by The Ethical Committee of the University Hospital Centre Zagreb (number: 02/21/JG. All patients included in the study signed informed consent.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The study was funded by project FAPIC (Fast assay for pathogen identification and characterization, Horizon 2020 programme, number: 634137).