prevalence, etiology, and antimicrobial resistance pattern of bacterial isolates from bloodstream infections in ganjavian hospital, dezful, iran

Background: sepsis is a life-threatening condition with high mortality rates. the emergence of antimicrobial resistance (amr) among pathogens that cause sepsis poses a significant challenge to effective treatment. this study was conducted to determine the amr patterns of bacterial isolates from septic patients' blood cultures with emphasis on extended-spectrum beta-lactamases (esbls), carbapenemase, and methicillin-resistant staphylococcus aureus (mrsa) prevalence. methods: this cross-sectional laboratory study examined blood culture samples of 1248 patients. the blood cultures were subcultured on macconkey and chocolate agar media. bacterial identification was based on gram-staining and biochemical tests. initial and confirmatory antibiotic susceptibility testing was then performed according to clsi 2022 for mrsa, vancomycin-resistant enterococcus (vre), and esbls. the statistical analysis of the study findings was conducted using spss. the accuracy level of the evaluations was determined with a 95% confidence interval.results: among the 174 cases of bloodstream infection (bsi) (13.9% positivity), enterobacterales (59.8%) and gram-positive cocci (32.7%) were dominant isolates. interestingly, the prevalence of mrsa was 67.5%, with a significantly higher prevalence in icus (81.3%; p=0.037). in gram-negative isolates, resistance to third-generation cephalosporins and carbapenems was 48.7% and 22.2%, respectively. significant resistance to carbapenems (80%) was observed in acinetobacter isolates, but all strains remained susceptible to colistin. esbl producers included escherichia coli (36.3%) and klebsiella pneumoniae (16%). notably, 52.4% of multidrug-resistant enterobacteriaceae cases were isolated from patients in emergency departments and intensive care units. conclusion: this study highlights the alarming prevalence of mdr bacteria among sepsis isolates. precautions should be taken against this growing threat by focusing on three priorities: enhancing infection control, maintaining continuous surveillance, and exploring novel therapeutic approaches.