Abstract
Introduction : Bacteremia is a serious health condition. The aim of this study is to identify the main multi-resistant Enterobacteriaceae responsible for bacteraemia and to analyze their antibiotic susceptibility profiles. Materials and methods : This is a descriptive, retrospective, single-center study over a period of 5 years, from January 1, 2016, to December 31, 2020, focusing on positive blood cultures with multi-resistant Enterobacteriaceae: Enterobacteriaceae resistant to third-generation cephalosporins (ERC3G) and Enterobacteriaceae resistant to carbapenems (ERC), from the various departments of Sahloul University Hospital in Sousse. Bacterial identification and antibiotic susceptibility test- ing were carried out according to the EUCAST/CA-SFM recommendations of the current year. Results : A total of 178 ERC3G strains were isolated from blood cultures out of a total of 596 Enterobacteriaceae (29.9%). The prevalence of ERC3G was 39% and 25% in surgical and inten- sive care units respectively. The urology department (19.1%) and the intensive care unit (12.4%) were the two main isolation departments for ERC3G. The ERC3Gs were represented by Klebsiella pneumoniae (48.3%), Escherichia coli (39.9%), and Enterobacter cloacae (7.5%). ERC3G isolat- ed from blood cultures were also resistant to ciprofloxacin (68.5%), levofloxacin (53%), gentamicin (49%), cefepime (76.9%) and cotrimoxazole (69.4%). In addition, 64 CRE were isolated (10.7%) from blood cultures positive for Enterobacteriaceae. The prevalence of CRE in intensive care units and surgical units was (42.2% and 40.6% respectively). The surgical intensive care unit (18.7%), the general post-operative department (18.8%) and the CCVT department (17.2%) were the three main CRE isolation departments. The main CRE isolated were K. pneumoniae (75%) and E. cloacae (14%). CRE were also resistant to gentamicin (71.88%), amikacin (42.2%), ciprofloxacin (92.1%), cefepime (89 %) and cotrimoxazole (60.9%). Conclusion : Active epidemiological surveillance of the susceptibility profile of bacteria isolated from blood cultures is necessary to ensure adequate management of bacteremia caused by multi- resistant enterobacteria.
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