Analysis of Prognostic Risk Factors of Bloodstream Infections in Beijing Communities: A Retrospective Study From 2015 to 2019

Liu, Yan; Cui, Beichen; Pi, Chun‐Mei; Yu, Xiaohong; Liu, Zhiwei; Li, Xiang; Ma, Longfei

doi:10.4084/mjhid.2021.060

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…A four-year domestically retrospective study showed that Gram-negative bacteria were most common pathogens among BSI patients, with Escherichia coli being the most frequently isolated pathogen 24 . In contrast, the predominant strains in our ICU were Klebsiella pneumoniae (43.67%) followed by Acinetobacter baumannii (16.9%), which differs from other relevant domestic studies in recent years 24 , 25 . Therefore, exploring the characteristics of bacterial strains in different regions is urgent for disease prevention and control and our study demonstrated a significant increase in the predominance of Gram-negative bacteria and carbapenem-resistant strains.…”

Section: Discussioncontrasting

confidence: 99%

Risk factors for bloodstream infection among patients admitted to an intensive care unit of a tertiary hospital of Shanghai, China

Cui,

Yi,

Zhang

et al. 2024

Sci Rep

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Blood flow infections (BSIs) is common occurrences in intensive care units (ICUs) and are associated with poor prognosis. The study aims to identify risk factors and assess mortality among BSI patients admitted to the ICU at Shanghai Ruijin hospital north from January 2022 to June 2023. Additionally, it seeks to present the latest microbiological isolates and their antimicrobial susceptibility. Independent risk factors for BSI and mortality were determined using the multivariable logistic regression model. The study found that the latest incidence rate of BSI was 10.11%, the mortality rate was 35.21% and the mean age of patients with BSI was 74 years old. Klebsiella pneumoniae was the predominant bacterial isolate. Logistic multiple regression revealed that tracheotomy, tigecycline, gastrointestinal bleeding, shock, length of hospital stay, age and laboratory indicators (such as procalcitonine and hemoglobin) were independent risk factors for BSI. Given the elevated risk associated with use of tracheotomy and tigecycline, it underscores the importance of the importance of cautious application of tracheostomy and empirical antibiotic management strategies. Meanwhile, the independent risk factors of mortality included cardiovascular disease, length of hospital stay, mean platelet volume (MPV), uric acid levels and ventilator. BSI patients exhibited a significant decrease in platelet count, and MPV emerged as an independent factor of mortality among them. Therefore, continuous monitoring of platelet-related parameters may aid in promptly identifying high-risk patients and assessing prognosis. Moreover, monitoring changes in uric acid levels may serve as an additional tool for prognostic evaluation in BSI patients.

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Section: Discussioncontrasting

confidence: 99%

Risk factors for bloodstream infection among patients admitted to an intensive care unit of a tertiary hospital of Shanghai, China

Cui,

Yi,

Zhang

et al. 2024

Sci Rep

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“…All of these adverse features above are risk factors for causing BSI and may make super-elderly patients with low immunity more vulnerable to BSI, just has been proved in many literatures. [17][18][19][20] And simultaneously, these adverse risk factors above were also related to the more severity of these super-elderly patients. Our results showed that the proportion of patients with a qSOFA score ≥ 2 was high up to 31.6% (136/431), which is a score closely associated with poor prognosis of various infection, including BSI, 21 especially sepsis and sepsis shock.…”

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confidence: 91%

Species Distribution, Typical Clinical Features and Risk Factors for Poor Prognosis of Super-Elderly Patients with Bloodstream Infection in China

Cui,

Li,

et al. 2024

IDR

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Objective Bloodstream infection (BSI) is characterized by high mortality, especially among these increasing super-elderly patients (≥85 years), and this study was conducted to understand the species distribution, typical clinical features and risk factors for poor prognosis of super-elderly patients with BSI. Methods Based on previous work, this retrospective study was performed by reviewing an ongoing prospective medical database in a comprehensive tertiary center in China, and all super-elderly patients with BSI in the past 6 years were enrolled in this study. Results Out of 5944 adult-patients with BSI, there were totally 431 super-elderly patients (≥85 years old) enrolled in this study and age ≥90 years accounted for 31.1% (134/431). Among these 431 super-elderly patients with BSI, 40 patients (9.3%) were diagnosed with BSI and the remained 401 super-elderly patients (90.7%) were defined as hospital-acquired BSI. The typical feature of these super-elderly patients with BSI was the high proportion of patients with various comorbidities, such as cardiovascular disease (83.8%), ischemic cerebrovascular disease (63.3%) and pulmonary infection (61.0%). The other typical feature was that most (60.1%) of these patients had been hospitalized for long time (≥28 days) prior to the onset of BSI, and most patients had received various invasive treatments, such as indwelling central venous catheter (53.1%) and indwelling urinary catheter (47.1%). Unfortunately, due to these adverse features above, both the 7-day short-term mortality (13.2%, 57/431) and the 30-day long-term mortality (24.8%, 107/431) were high. The multivariate analysis showed that both chronic liver failure (OR 7.9, 95% CI 2.3–27.8, P =0.001) and indwelling urinary catheter (OR 2.3, 95% CI 1.1–4.7, P =0.023) were independent risk factors for 7-day short-term mortality, but not for 30-day long-term mortality. In addition, the microbiology results showed that the most common species were associated with nosocomial infection or self-opportunistic infection, such as Staphylococcus hominis (18.3%), Staphylococcus epidermidis (11.8%), Escherichia coli (9.7%), Klebsiella pneumoniae (9.3%) and Candida albicans (8.6%, fungi). Conclusion Super-elderly patients with BSI had typical features, regardless of the pathogenic species distribution and their drug resistance, or clinical features and their risk factors for poor prognosis. These typical features deserved attention and could be used for the prevention and treatment of BSI among super-elderly patients.

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“… 5 , 6 Solid tumors, combined septic shock, indwelling catheters and continuous venovenous hemofiltration were independent risk factors affecting the prognosis of BSI patients. 7 Appropriate use of antibiotics is critical for their treatment and prognosis. At present, China is one of the largest users of antibiotics worldwide, 8 and antibiotic overuse remains a serious problem worldwide.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance Among Pathogens Causing Bloodstream Infections: A Multicenter Surveillance Report Over 20 Years (1998–2017)

Zhang¹,

Sun²,

Tian³

2022

IDR

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Purpose Bloodstream infections (BSIs) are a common consequence of infectious diseases and cause high morbidity and mortality. Appropriate antibiotic use is critical for patients’ treatment and prognosis. Long-term monitoring and analysis of antimicrobial resistance are important in guiding physicians to choose appropriate antibiotics and understand the changes in antimicrobial resistance and infection control. Here, we report a retrospective study on the trends of antimicrobial resistance in the common BSI-associated pathogens. Methods The identification of strains and antimicrobial susceptibility tests were performed in each anticipating hospital independently. Data from the Hubei Province Antimicrobial Resistance Surveillance System (HBARSS) from 1998 to 2017 were retrospectively analyzed using WHONET 5.6 software. Results Data from HBARSS (1998–2017) revealed that 40,518 Gram-positive bacteria and 26,568 Gram-negative bacteria caused BSIs, the most common of which were Staphylococcus aureus and Escherichia coli. Salmonella typhi was a predominant BSI-associated pathogen in 1998–2003. Antimicrobial susceptibility data showed that the resistance rates of E. coli and Klebsiella pneumoniae to cefotaxime were significantly higher than those to ceftazidime. The proportion of strains of special antimicrobial resistance phenotypes including difficult-to-treat resistance (DTR), carbapenem-resistant (CR), extended-spectrum cephalosporin resistant (ECR) and fluoroquinolone resistant (FQR) in E. coli was 0.18%, 0.26%, 13.95%, 22.78% while in K. pneumoniae was 11.95%, 14.00%, 31.91% and 11.40%, respectively. In 2013–2017, K. pneumoniae showed resistance levels reaching 15.8% and 17.5% to imipenem and meropenem, respectively, and Acinetobacter baumannii showed high resistance rates ranging from 60 to 80% to common antibiotics. The detection rate of Salmonella typhi resistance to third-generation cephalosporins and fluoroquinolones was less than 5%. Control of methicillin-resistant Staphylococcus aureus (MRSA) remains a major challenge, and in 2009–2017, the MRSA detection rate was 40–50%. Conclusion Prevalence of CR K. pneumoniae has increased significantly in recent years. Resistance rates of A. baumannii to common antimicrobial agents have increased exponentially, reaching high levels. MRSA remains a challenge to control. For K. pneumoniae, DTR, CR, ECR and FQR were antimicrobial resistance phenotypes that could not be ignored while for E. coli DTR and CR were rare antimicrobial resistance phenotypes. CR K. pneumoniae, A. baumannii ...

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Analysis of Prognostic Risk Factors of Bloodstream Infections in Beijing Communities: A Retrospective Study From 2015 to 2019

Cited by 5 publications

References 26 publications

Risk factors for bloodstream infection among patients admitted to an intensive care unit of a tertiary hospital of Shanghai, China

Risk factors for bloodstream infection among patients admitted to an intensive care unit of a tertiary hospital of Shanghai, China

Species Distribution, Typical Clinical Features and Risk Factors for Poor Prognosis of Super-Elderly Patients with Bloodstream Infection in China

Antimicrobial Resistance Among Pathogens Causing Bloodstream Infections: A Multicenter Surveillance Report Over 20 Years (1998–2017)

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