Bloodstream Infection By Multidrug-Resistant ENTEROBACTERIACEAE In Midwest BRAZIL: Risk Factors And Clinical Evolution

This study describes resistance genes in Enterobacteriaceae isolates, risk factors and clinical evolution of 40 patients with bloodstream infection (BSI) from Intensive Care Units and Emergency Care in a tertiary hospital from Campo Grande, MS, Brazil. Clinical data was collected from medical records. Bacterial identification was performed by VITEK-2 system. Phenotypic detection of carbapenemases were screened by the Carbapenem Inactive Method. BlaKPC and mcr-1 genes were investigated by Polymerase Chain Reaction. Patients aged 60 years or over (15; 7.5%) and patients under one year (13; 32.5%) represented the majority. Twenty-five patients (62.5%) were admitted to the ICU for eight days or more. Seventeen patients died (42.5%). The length of stay in the ICU (p=0.028), use of central venous access (p=0.026) and mechanical ventilation (p=0.007) were associated with mortality. Klebsiella pneumoniae and Echerichia coli were the main bacteria isolated from blood cultures. Twenty-two (55%) were resistant to carbapenems, and four (10%) to polymyxin. BlaKPC gene was detected in 37.5%. Mcr- 1 gene was not detected. Immune senescence, immature immune system and invasive procedures are considered risk factors for BSI. This infection caused by multidrug resistant enterobacteria is associated with elevated mortality.