Distribution of pathogens and antimicrobial resistance in bacteraemia according to hospitalization duration: a nationwide surveillance study in Switzerland

Abstract

Objectives: Changing microorganism distributions and decreasing antibiotic susceptibility with increasing length of hospital stay have been demonstrated for the colonization or infection of selected organ systems. We wanted to describe microorganism distribution or antibiotic resistance in bacteraemia according to duration of the hospitalization using a large national epidemiological/microbiological database (ANRESIS) in Switzerland. Methods: We conducted a nationwide, observational study on bacteraemia using ANRESIS data from 1 January 2008 to 31 December 2017. We analysed data on bacteraemia from those Swiss hospitals that sent information on a regular basis during the entire study period. We described the pathogen distribution and specific trends of resistance during hospitalization for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Serratia marcescens and Staphylococcus aureus. Results: We included 28 318 bacteraemia isolates from 90 Swiss hospitals. The most common aetiology was E. coli (33.4%, 9459), followed by S. aureus (16.7%, 4721), K. pneumoniae (7.1%, 2005), Enterococcus faecalis (5.2%, 1473), P. aeruginosa (4.3%, 1228), Streptococcus pneumoniae (4.3%, 1208) and Enterococcus faecium (3.9%, 1101). We observed 489 (1.73%) S. marcescens isolates. We observed an increasing trend for E. faecium (from 1.5% at day 0 to 13.7% at day 30; p < 0.001), K. pneumoniae (from 6.1% to 7.8%, p < 0.001) and P. aeruginosa (from 2.9% to 13.7%, p < 0.001) with increasing duration of hospitalization; and decreasing trends for E. coli (from 41.6% to 21.6%; p < 0.001) and S. aureus (p < 0.001). Ceftriaxone resistance among E. coli remained stable for the first 15 days of hospitalization and then increased. Ceftriaxone resistance among K. pneumoniae and S. marcescens and oxacillin resistance among S. aureus increased linearly during the hospitalization. Cefepime resistance among P. aeruginosa remained stable during the hospitalization. Discussion: We showed that hospitalization duration is associated with a species-and antibiotic classdependent pattern of antimicrobial resistance.

Bacteremia During the First Year After Solid Organ Transplantation: An Epidemiological Update

“…This is in contrast to MDR pathogen rates as high as 20%–25%, 8%, and 57% in kidney, liver, and lung transplant recipients, respectively [ 4 , 6 , 39 , 42 ]. The low MDR incidence in SOT recipients in our cohort reflects the general trend of infections due to MDR bacterial pathogens in Switzerland, as reported by the ANRESIS network [ 43 , 44 ]. Although those data are in accordance with the general epidemiology in our country, they also suggest that close control and monitoring of transplant prophylactic and treatment strategies by experienced transplant infectious disease teams in all transplant centers in Switzerland might have contributed to keeping antibiotic resistance low in this fragile patient population.…”

Distribution of pathogens and antimicrobial resistance in ICU-bloodstream infections during hospitalization: a nationwide surveillance study

“…We conducted a nationwide, observational study on BSI using data from the Swiss Centre for Antibiotic Resistance (ANRESIS) data from 1st January 2008 to 31st December 2017. ANRESIS regularly receives information on all positive blood cultures from 30 Swiss microbiology laboratories, some of them collecting data from several hospitals 8 . Hospitals are distributed across the country and representing at least 80% of annual hospitalization days 9 .…”

“…Resistant isolates were defined as those who were resistant or displayed intermediate susceptibility against the antibiotic tested. Resistance against first-line antibiotics was defined as resistance against amoxicillin for enterococci, ceftriaxone and/or amoxicillin/clavulanic acid for Gram-negative microorganisms and oxacillin for Staphylococcus aureus 8 . All non-fermenting Gram-negative bacteria were considered as resistant to first-line antibiotics as detailed above.…”

Risk factors of multidrug-resistant organisms neonatal sepsis in Surabaya tertiary referral hospital: a single-center study

“…Conversely, a case-control study of 248 neonates in southwest Ethiopia found that meconiumstained amniotic fluid was not a risk factor for developing neonatal sepsis [12]. Manandhar S. et al (2021) reported the same finding in Nepal [33].…”