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Blood stream infections rank among the top seven causes of death of the general population. The aim of our study was to better understand the epidemiology of BSI in order to improve diagnostics and patient outcome. We used retrospective aggregated laboratory data of blood samples received from all public hospitals in Tyrol, Austria between 2006 and 2015. Microorganisms were categorized into obligatory, facultative, unusual pathogens and contaminants. The distribution, the cumulative incidence and antimicrobial susceptibility patterns were compared between the tertiary (TH) and regional peripheral hospitals (PH). Among 256,364 blood samples, 76.1% were from the TH The incidence of obligatory pathogens was 1.7 fold, and up to 3 times higher for facultative, unusual pathogens and contaminants in the TH and increased mainly due to an increase of E.coli, which was the most common isolated pathogen (n = 2,869), followed by Staphylococcus aureus (n = 1,439), Enterococcus sp. (n = 953) and Klebsiella sp. (n = 816). The distribution of obligatory pathogens differed between the hospital settings: In the TH Enterococcus sp. accounted for 40.8% and E.coli for 70.4%, respectively, whereas in the PH for 25.4% (p<0.0001) and 57.8%, respectively (p<0.0001) Antibiotic resistance of Gram negative bacteria and Staphylococcus aureus did not change during the observation period. Carbapenem resistance of Klebsiella sp. and vancomycin and linezolid resistance of Enterococcus faecium showed a non-significant increase since 2010 in the TH setting. We concluded that the incidence of BSI in TH was higher compared to PH. We observed higher contamination rates in the TH. We could not interpret the data of coagulase negative staphylococci due to lack of clinical data. We strongly recommend enhancement of training on blood culture sampling to decrease the rate of contamination. Due to differences in pathogen distribution and antimicrobial resistance between different hospital settings we recommend separate treatment guidelines for BSI by hospital setting. [ABSTRACT FROM AUTHOR]

The prevalence of Listeria monocytogenes in different types of produce and on processing plant environments was investigated over a 4-year period in a large produce processing plant in Poland. Prevalence of L. monocytogenes was 46% in frozen vegetables and 41.3% in swab samples taken from the plant environment. Survival studies using artificial inocula demonstrated that the number of Listeria in frozen produce stored for 100 days did not significantly decrease in relation to the initial contamination level. A subset of 129 L. monocytogenes isolates originating from produce and the plant environment were typed by pulsed-field gel electrophoresis. Seventy-six of these isolates were retyped by ribo- and serotyping. Thirteen pulsotypes and 18 ribotypes were distinguished. Persistent Listeria isolates were found even when cleansing and sanitization was applied on a daily basis. Nine (69.2%) of 13 pulsotypes were recovered during a period of more than 2 years. L. monocytogenes of the same pulsotype was isolated from broccoli sampled directly before and after blanching, thus suggesting that blanching at 92 to 95°C for 4 to 8 min did not result in a Listeria-free product, most likely due to massive recontamination. This finding is of importance since blanching is the only critical control point in produce processing. Cross-contamination between the two lines was demonstrated through isolating L. monocytogenes strains indistinguishable by pulsed-field gel electrophoresis from contaminated gloves and floor surfaces. [ABSTRACT FROM AUTHOR]