Anaerobic bloodstream infections in Italy (ITANAEROBY): A 5-year retrospective nationwide survey - PubMed (original) (raw)

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doi: 10.1016/j.anaerobe.2022.102583. Epub 2022 May 11.

Roberta Maria Antonello 2, Gianfranco Sanson 3, Alberto Enrico Maraolo 4, Daniele Roberto Giacobbe 5, Chiara Sepulcri 6, Simone Ambretti 7, Richard Aschbacher 8, Laura Bartolini 9, Mariano Bernardo 10, Alessandra Bielli 11, Marina Busetti 12, Davide Carcione 13, Giulio Camarlinghi 14, Edoardo Carretto 15, Tiziana Cassetti 16, Chiara Chilleri 17, Francesco Giuseppe De Rosa 18, Saveria Dodaro [ 19](#full-view-affiliation-19 "Microbiology and Virology Unit, "Annunziata" Hospital of Cosenza, Cosenza, Italy. Electronic address: s.dodaro@libero.it."), Raffaele Gargiulo 20, Francesca Greco [ 21](#full-view-affiliation-21 "Microbiology and Virology Unit, "Annunziata" Hospital of Cosenza, Cosenza, Italy."), Anna Knezevich 22, Jari Intra 23, Tommaso Lupia 24, Erika Concialdi 25, Gabriele Bianco 26, Francesco Luzzaro [ 27](#full-view-affiliation-27 "Clinical Microbiology and Virology Unit, "A. Manzoni" Hospital, Lecco, Italy. Electronic address: f.luzzaro@asst-lecco.it."), Carola Mauri [ 28](#full-view-affiliation-28 "Clinical Microbiology and Virology Unit, "A. Manzoni" Hospital, Lecco, Italy."), Gianluca Morroni 29, Adriana Mosca [ 30](#full-view-affiliation-30 "Interdisciplinary Department of Medicine (DIM), University of Bari "Aldo Moro", Policlinico, Bari, Italy. Electronic address: adriana.mosca@uniba.it."), Elisabetta Pagani 31, Eva Maria Parisio 32, Claudio Ucciferri [ 33](#full-view-affiliation-33 "Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy. Electronic address: claudio.ucciferri@unimol.it."), Chiara Vismara 34, Roberto Luzzati 35, Luigi Principe [ 36](#full-view-affiliation-36 "Clinical Pathology and Microbiology Unit, "San Giovanni di Dio" Hospital, Crotone, Italy. Electronic address: luigi.principe@gmail.com.")

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Anaerobic bloodstream infections in Italy (ITANAEROBY): A 5-year retrospective nationwide survey

Stefano Di Bella et al. Anaerobe. 2022 Jun.

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Abstract

Introduction: A lack of updated data on the burden and profile of anaerobic bloodstream infections (ABIs) exists. We assessed the incidence of ABIs and trends in antimicrobial resistance in anaerobes isolated from blood in Italy.

Material and methods: We conducted a retrospective study on 17 Italian hospitals (2016-2020). Anaerobes isolated from blood culture and their in vitro susceptibility profiles (EUCAST-interpreted) were registered and analyzed.

Results: A total of 1960 ABIs were identified. The mean age of ABIs patients was 68.6 ± 18.5 years, 57.6% were males. The overall incidence rate of ABIs was 1.01 per 10.000 patient-days. Forty-seven% of ABIs occurred in medical wards, 17% in ICUs, 14% in surgical wards, 7% in hemato-oncology, 14% in outpatients. The three most common anti-anaerobic tested drugs were metronidazole (92%), clindamycin (89%) and amoxicillin/clavulanate (83%). The three most common isolated anaerobes were Bacteroides fragilis (n = 529), Cutibacterium acnes (n = 262) and Clostridium perfringens (n = 134). The lowest resistance rate (1.5%) was to carbapenems, whereas the highest rate (51%) was to penicillin. Clindamycin resistance was >20% for Bacteroides spp., Prevotella spp. and Clostridium spp. Metronidazole resistance was 9.2% after excluding C. acnes and Actinomyces spp. Bacteroides spp. showed an increased prevalence of clindamycin resistance through the study period: 19% in 2016, 33% in 2020 (p ≤ 0.001).

Conclusions: Our data provide a comprehensive overview of the epidemiology of ABIs in Italy, filling a gap that has existed since 1995. Caution is needed when clindamycin is used as empirical anti-anaerobic drug.

Keywords: Anaerobes; Antimicrobial resistance; Bacteremia; Bloodstream infection; Italy.

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