Clinical and microbiological perspectives on multidrug-resistant gram-negative pathogens in bloodstream infections.

Abstract

Introduction: Bloodstream infections (BSIs) caused by multidrug-resistant (MDR) Gram-negative bacilli pose a significant challenge in healthcare settings around the world. The main objective of this research was to determine the incidence, etiology, risk factors, and sources of BSIs among patients treated at Sohar Hospital in Oman.

Methods: The study employed a retrospective methodology at Sohar Hospital, Oman, analyzing patients with BSIs from January 2018 to December 2019 utilizing electronic health data. Demographic data, bacterial etiology, antibiotic susceptibility, and patient outcomes were obtained from electronic health records. The statistical tools employed comprised t-tests, Mann-Whitney tests, Chi-square tests, and Fisher's exact tests for variable comparison, alongside univariate odds ratios computed for mortality correlations utilizing the R package GTSUMMARY. Bacterial identification and testing was performed in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines utilizing both traditional methods and automated technologies.

Results: The majority of BSIs occur in elderly individuals with comorbidities. Surgical intervention was identified as a predominant risk factor for adverse consequences. MDR infections were linked with higher mortality rates. Klebsiella pneumoniae and Acinetobacter baumannii were prevalent, with K. pneumoniae exhibiting resistance to several antibiotics.

Conclusions: The study highlights the urgent requirement for effective monitoring, management and infectious control measures to reduce the impact of BSIs and MDR pathogens on patient outcomes. It contributes valuable insights into the local epidemiology of BSIs in Oman. It emphasizes the significance of tailored interventions and precise medications to address the growing threat of antimicrobial resistance in healthcare settings.