Epidemiology and Resistance Profiles of Bacteria Isolated From Blood Samples in Septic Patients at Emergency Department Admission: A 6-Year Single Centre Retrospective Analysis From Northern Italy
Objective: This study aimed to investigate the microbiological and clinical heterogeneity of community-onset bloodstream infections (BSIs) and identify features to support targeted empirical antibiotic therapy in the Emergency Department (ED). Methods: Clinical and microbiological data from 992 BSI...
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Elsevier
2025-03-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524004752 |
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| author | Valeria Cento Sara Carloni Riccardo Sarti Linda Bussini Zian Asif Paola Morelli Francesco De Fazio Federica Maria Tordato Maddalena Casana Debora Mondatore Antonio Desai Elena Generali Nicola Pugliese Elena Costantini Massimo Vanoni Maurizio Cecconi Stefano Aliberti Giorgio Da Rin Erminia Casari Michele Bartoletti Antonio Voza |
| author_facet | Valeria Cento Sara Carloni Riccardo Sarti Linda Bussini Zian Asif Paola Morelli Francesco De Fazio Federica Maria Tordato Maddalena Casana Debora Mondatore Antonio Desai Elena Generali Nicola Pugliese Elena Costantini Massimo Vanoni Maurizio Cecconi Stefano Aliberti Giorgio Da Rin Erminia Casari Michele Bartoletti Antonio Voza |
| author_sort | Valeria Cento |
| collection | DOAJ |
| description | Objective: This study aimed to investigate the microbiological and clinical heterogeneity of community-onset bloodstream infections (BSIs) and identify features to support targeted empirical antibiotic therapy in the Emergency Department (ED). Methods: Clinical and microbiological data from 992 BSI cases (1,135 isolates) diagnosed within 24 h of ED admission at IRCCS Humanitas Research Hospital, Milan, Italy (January 2015–June 2022), were analysed. Drug resistance was interpreted using EUCAST-2023. Clinical features included age, sex, comorbidities (e.g., cancer, diabetes), infection source, presence of central venous catheters (CVC), ongoing therapies, and sepsis severity. Microbiological data included pathogen identification and antimicrobial susceptibility. Results: Antibiotic-susceptible Escherichia coli (29.5%) was the most common isolate, including extended-spectrum beta-lactamase (ESBL)-producing strains (11.3%), followed by methicillin-susceptible Staphylococcus aureus (MSSA, 8.4%). BSIs due to E. coli were more frequent in patients >60 years (43.9% vs. 27.3%, P < 0.001) and associated with ESBL production (OR = 2.202, P = 0.031) and urosepsis (OR = 1.688, P = 0.006). Younger patients (≤60 years) had more S. aureus-associated BSIs (22.4% vs. 10.8%, P < 0.001) and methicillin resistance (7.9% vs. 3.6%, P = 0.021). Carbapenem-resistant Enterobacterales were rare (2.1%-2.8%), predominantly involving Klebsiella pneumoniae. Onco-hematological patients had a lower multidrug-resistance prevalence (9.5% vs. 21.1%, P < 0.001). Conclusions: Community-onset BSIs demonstrated substantial prevalence of resistant pathogens, including ESBL and MRSA, emphasizing the need for robust surveillance systems. Age is a critical factor in guiding empirical antibiotic therapy in the ED. |
| format | Article |
| id | doaj-art-b81b539077de446c89f603dd3381998d |
| institution | Kabale University |
| issn | 2213-7165 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
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| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj-art-b81b539077de446c89f603dd3381998d2025-02-09T05:00:25ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-03-0141202210Epidemiology and Resistance Profiles of Bacteria Isolated From Blood Samples in Septic Patients at Emergency Department Admission: A 6-Year Single Centre Retrospective Analysis From Northern ItalyValeria Cento0Sara Carloni1Riccardo Sarti2Linda Bussini3Zian Asif4Paola Morelli5Francesco De Fazio6Federica Maria Tordato7Maddalena Casana8Debora Mondatore9Antonio Desai10Elena Generali11Nicola Pugliese12Elena Costantini13Massimo Vanoni14Maurizio Cecconi15Stefano Aliberti16Giorgio Da Rin17Erminia Casari18Michele Bartoletti19Antonio Voza20Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Corresponding author: Sara Carloni, Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyIRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyIRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyIRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyIRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyIRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyIRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyIRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyIRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyHumanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyObjective: This study aimed to investigate the microbiological and clinical heterogeneity of community-onset bloodstream infections (BSIs) and identify features to support targeted empirical antibiotic therapy in the Emergency Department (ED). Methods: Clinical and microbiological data from 992 BSI cases (1,135 isolates) diagnosed within 24 h of ED admission at IRCCS Humanitas Research Hospital, Milan, Italy (January 2015–June 2022), were analysed. Drug resistance was interpreted using EUCAST-2023. Clinical features included age, sex, comorbidities (e.g., cancer, diabetes), infection source, presence of central venous catheters (CVC), ongoing therapies, and sepsis severity. Microbiological data included pathogen identification and antimicrobial susceptibility. Results: Antibiotic-susceptible Escherichia coli (29.5%) was the most common isolate, including extended-spectrum beta-lactamase (ESBL)-producing strains (11.3%), followed by methicillin-susceptible Staphylococcus aureus (MSSA, 8.4%). BSIs due to E. coli were more frequent in patients >60 years (43.9% vs. 27.3%, P < 0.001) and associated with ESBL production (OR = 2.202, P = 0.031) and urosepsis (OR = 1.688, P = 0.006). Younger patients (≤60 years) had more S. aureus-associated BSIs (22.4% vs. 10.8%, P < 0.001) and methicillin resistance (7.9% vs. 3.6%, P = 0.021). Carbapenem-resistant Enterobacterales were rare (2.1%-2.8%), predominantly involving Klebsiella pneumoniae. Onco-hematological patients had a lower multidrug-resistance prevalence (9.5% vs. 21.1%, P < 0.001). Conclusions: Community-onset BSIs demonstrated substantial prevalence of resistant pathogens, including ESBL and MRSA, emphasizing the need for robust surveillance systems. Age is a critical factor in guiding empirical antibiotic therapy in the ED.http://www.sciencedirect.com/science/article/pii/S2213716524004752Antibiotic resistanceBSIESBL |
| spellingShingle | Valeria Cento Sara Carloni Riccardo Sarti Linda Bussini Zian Asif Paola Morelli Francesco De Fazio Federica Maria Tordato Maddalena Casana Debora Mondatore Antonio Desai Elena Generali Nicola Pugliese Elena Costantini Massimo Vanoni Maurizio Cecconi Stefano Aliberti Giorgio Da Rin Erminia Casari Michele Bartoletti Antonio Voza Epidemiology and Resistance Profiles of Bacteria Isolated From Blood Samples in Septic Patients at Emergency Department Admission: A 6-Year Single Centre Retrospective Analysis From Northern Italy Journal of Global Antimicrobial Resistance Antibiotic resistance BSI ESBL |
| title | Epidemiology and Resistance Profiles of Bacteria Isolated From Blood Samples in Septic Patients at Emergency Department Admission: A 6-Year Single Centre Retrospective Analysis From Northern Italy |
| title_full | Epidemiology and Resistance Profiles of Bacteria Isolated From Blood Samples in Septic Patients at Emergency Department Admission: A 6-Year Single Centre Retrospective Analysis From Northern Italy |
| title_fullStr | Epidemiology and Resistance Profiles of Bacteria Isolated From Blood Samples in Septic Patients at Emergency Department Admission: A 6-Year Single Centre Retrospective Analysis From Northern Italy |
| title_full_unstemmed | Epidemiology and Resistance Profiles of Bacteria Isolated From Blood Samples in Septic Patients at Emergency Department Admission: A 6-Year Single Centre Retrospective Analysis From Northern Italy |
| title_short | Epidemiology and Resistance Profiles of Bacteria Isolated From Blood Samples in Septic Patients at Emergency Department Admission: A 6-Year Single Centre Retrospective Analysis From Northern Italy |
| title_sort | epidemiology and resistance profiles of bacteria isolated from blood samples in septic patients at emergency department admission a 6 year single centre retrospective analysis from northern italy |
| topic | Antibiotic resistance BSI ESBL |
| url | http://www.sciencedirect.com/science/article/pii/S2213716524004752 |
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