Multidrug-Resistant Bloodstream Infections in Internal Medicine: Results from a Single-Center Study.

Area of Science:

• Infectious Diseases
• Internal Medicine
• Microbiology

Background:

• Multidrug-resistant organisms (MDROs) pose a growing global threat, leading to increased mortality and healthcare costs.
• Understanding trends and risk factors for MDRO infections in specific clinical settings is crucial for effective management.

Purpose of the Study:

• To analyze trends in MDRO bacteremia and antimicrobial resistance rates within Internal Medicine wards.
• To identify clinical and demographic variables associated with MDRO infections in this patient population.

Main Methods:

• A 6-year retrospective study (2011-2017) of patients with positive blood cultures in Internal Medicine wards.
• Analysis of time trends and frequencies of MDRO infections.
• A case-control study to identify associated clinical-demographic variables.

Main Results:

• Escherichia coli, Staphylococcus aureus, and S. epidermidis were the most common isolates.
• Decreasing methicillin resistance in S. aureus contrasted with increasing rates of extended-spectrum β-lactamase-producing Enterobacteriaceae and carbapenemase-producing Klebsiella pneumoniae.
• Nosocomial origin, recent hospitalization/antibiotic exposure, long-term care residence, device presence, and cerebrovascular disease were independently associated with MDRO bacteremia.

Conclusions:

• The study highlights a concerning microbiological situation in Internal Medicine, consistent with national and regional data.
• Identified risk variables for MDRO infection align with existing literature, though Internal Medicine-specific studies remain limited.