Infectious diseases & clinical microbiology · 2026
Susceptibility Trends of Enterobacterales Isolated from Blood Culture Samples: A Four-Year Analysis with the Rise of Carbapenem Resistance.
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Ibnouf Sondos A A, Yağcı Burcu, Mohamed Mahir Eissa, Doğan Metin
Аннотация
OBJECTIVE: Bloodstream infections (BSIs) caused by Enterobacterales pose a significant challenge in healthcare, especially given the growing threat of antimicrobial resistance. This study aimed to evaluate the distribution and antimicrobial susceptibility patterns of Enterobacterales isolated from blood cultures at Necmettin Erbakan University Meram School of Medicine Hospital in Konya, Türkiye, over a four-year period.
MATERIALS AND METHODS: A retrospective laboratory-based analysis was conducted using blood culture samples collected between January 2020 and January 2023. Bacterial identification and antimicrobial susceptibility testing were performed using the BD Phoenix system. Results were interpreted according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines (version 15.0). Demographic and clinical data were analyzed using descriptive statistics.
RESULTS: A total of 11,319 blood culture samples were analyzed during the study period. Enterobacterales were isolated from 1513 patients, with Klebsiella pneumoniae (52.2%) and Escherichia coli (34.9%) being the most prevalent pathogens. High resistance rates were observed for ampicillin (91.7%) and amoxicillin-clavulanic acid (76.7%) in E. coliand particularly among Klebsiella spp. (98.9% and 85%, respectively). Extended-spectrum β-lactamase (ESBL) production was detected in 81% of Klebsiella spp., and approximately 47% of E. coli isolates.Colistin emerged as the most effective antibiotic. Notably, Klebsiella spp. also exhibited elevated carbapenem resistance (58.1%), whereas E. coli showed low resistance to both colistin (0.6%) and meropenem (1.5%). The rate of ESBL production peaked at 75.5% in 2020, then declined before rising again to 63.7% in 2023. Carbapenem-resistant isolates fluctuated around 33% of total isolates annually; however, in 2023, this rate increased to 36.3%, suggesting a potential upward trend.
CONCLUSION: The findings indicate a concerning burden of carbapenem-resistant Klebsiella spp. among Enterobacterales BSI, with colistin remaining the most consistently effective agent. Continuous surveillance, effective infection control measures, and prudent antibiotic use are essential to limit further resistance.
GRAPHIC ABSTRACT: Graphic Abstract.
MATERIALS AND METHODS: A retrospective laboratory-based analysis was conducted using blood culture samples collected between January 2020 and January 2023. Bacterial identification and antimicrobial susceptibility testing were performed using the BD Phoenix system. Results were interpreted according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines (version 15.0). Demographic and clinical data were analyzed using descriptive statistics.
RESULTS: A total of 11,319 blood culture samples were analyzed during the study period. Enterobacterales were isolated from 1513 patients, with Klebsiella pneumoniae (52.2%) and Escherichia coli (34.9%) being the most prevalent pathogens. High resistance rates were observed for ampicillin (91.7%) and amoxicillin-clavulanic acid (76.7%) in E. coliand particularly among Klebsiella spp. (98.9% and 85%, respectively). Extended-spectrum β-lactamase (ESBL) production was detected in 81% of Klebsiella spp., and approximately 47% of E. coli isolates.Colistin emerged as the most effective antibiotic. Notably, Klebsiella spp. also exhibited elevated carbapenem resistance (58.1%), whereas E. coli showed low resistance to both colistin (0.6%) and meropenem (1.5%). The rate of ESBL production peaked at 75.5% in 2020, then declined before rising again to 63.7% in 2023. Carbapenem-resistant isolates fluctuated around 33% of total isolates annually; however, in 2023, this rate increased to 36.3%, suggesting a potential upward trend.
CONCLUSION: The findings indicate a concerning burden of carbapenem-resistant Klebsiella spp. among Enterobacterales BSI, with colistin remaining the most consistently effective agent. Continuous surveillance, effective infection control measures, and prudent antibiotic use are essential to limit further resistance.
GRAPHIC ABSTRACT: Graphic Abstract.