Distribution of clinical isolates obtained from sterile body fluids: a four-year retrospective data

Abstract

Aim: Infections of sterile body fluids (SBFs) require rapid and accurate diagnosis and treatment, since their morbidities and mortalities are high. To achieve this goal, definite epidemiologic data is absolutely required, since empiric and preemptive treatments are mainly based on this. The aim of this study was to evaluate infectious agents isolated from SBFs, susceptibility results and molecular analysis (PCR) data, retrospectively. Material and Method: Clinical samples of SBFs (Cerebrospinal, pleural, peritoneal, pericardial and synovial fluids) obtained from January 2017 to December 2020 in Atatürk City Hospital (tertiary center) were included. Identification of bacterial and fungal agents and antibiotic susceptibility were done by conventional and automated system (BD Phoenix™, Becton Dickinson Co., Sparks, MD, USA). Löwenstein-Jensen media and BACTEC Mycobacteria Growth Indicator Tube 960 (Becton Dickinson Co., Sparks, MD, USA) were used for mycobacterial analysis. Bosphore Viral Meningitis Panel Multiplex PCR Kit (Anatolia Geneworks, İstanbul, Turkey) were applied to detect HSV-1, HSV-2, VZV, Enterovirus and/or Parechovirus. Results: A total of 221 (9.74%) organisms were detected among 2269 samples. Particularly common gram negative bacterial agents covered the top of the list (Escherichia coli, Pseudomonas spp., Klebsiella spp. and Acinetobacter baumannii-Acinetobacter calcoaceticus complex). Staphylococcus aureus was the most frequent gram positive strain, followed by enteroccocci. Most of the A. baumannii isolates were multidrug resistant, Pseudomonas spp. showed over than 20% resistance rate to ceftazidime, cefepime and piperacillin-tazobactam. All enterococci were vancomycin-susceptible, one S. aureus strain was methicillin-resistant. All Mycobacterium tuberculosis complex isolates were found to be susceptible to first-line anti-tuberculosis drugs. Conclusions: Continuous laboratory surveillance even in local phase is important to guide clinicians. Even though our data did not show significant changes, improvements on laboratory capabilities and clinical awareness must be done. Isolation rates might be underestimated due to requirement of improvements in our laboratory, especially about sampling, anaerobe transportation and usage of blood culture vials.