Antimicrobial resistance trends - a single-center retrospective study of healthcare-associated pathogens - postmortem sampling from medico-legal autopsies in Bucharest.

Introduction: Healthcare-associated infections are a major concern for healthcare systems around the world. Microorganisms developing resistance to potent antibiotics are an urgent threat to public health. Methods: The present study is a retrospective, single-center study performed at the Mina Minovici National Institute of Legal Medicine, Bucharest, Romania, over a period of ten years (2011-2020). Autopsies for deaths occurring in the hospital setting for which postmortem bacteriological examination was solicited were screened and the recovered data consisted of demographics, hospital stay duration, autopsy data, and postmortem microbiology. Results: In the 516 autopsies recovered we found that carbapenemase-producing Enterobacteriaceae (CPE) isolates from postmortem bacteriology results increased in 2019. Positive postmortem microbiology results were associated with histological infection in over 80% of cases. Positive results for healthcare-related pathogens were associated with prolonged hospital stay. In our data vancomycin-resistant enterococci were isolated from 2015. Conclusions: Postmortem bacteriology results from medico-legal autopsies mirror antimicrobial resistance trends from hospital settings with several limitations due to the scarcity of solicitations.