Healthcare-associated bloodstream infections in critically ill patients: descriptive cross-sectional database study evaluating concordance with clinical site isolates

Abstract

BackgroundHealthcare-associated bloodstream infections are related to both increased antibiotic use and risk of adverse outcomes. An in-depth understanding of their epidemiology is essential to reduce occurrence and to improve outcomes by targeted prevention strategies. The objectives of the study were to determine the epidemiology, source and concordance of healthcare-associated bloodstream infections with clinical site isolates.MethodsWe conducted a descriptive cross-sectional study in critically ill adults admitted to a tertiary semi-closed intensive care unit in England to determine the epidemiology, source and concordance of healthcare-associated bloodstream infections with clinical site isolates. All nosocomial positive blood cultures over a 4-year study period were identified. Pathogens detected and concordances with clinical site are reported as proportions.ResultsContaminant pathogens accounted for half of the isolates. The most common non-contaminant pathogens cultured were Pseudomonas spp. (8.0%), Enterococcus spp. (7.3%) and Escherichia coli (5.6%). Central venous catheter-linked bloodstream infections represent only 6.0% of the positive blood cultures. Excluding contaminants and central venous line infections, in only 39.5% of the bloodstream infections could a concordant clinical site source be identified, the respiratory and urinary tracts being the most common.ConclusionsClinical practice should focus on a) improving blood culture techniques to reduce detection of contaminant pathogens and b) ensuring paired clinical site cultures are performed alongside all blood cultures to better understand the epidemiology and potential implications of primary and secondary discordant health-care associated bloodstream infections.

Prevalence and Antimicrobial Resistance Pattern of Blood Isolates in Patients of Septicemia in ICU: Single Centre Observation

“…This finding is in agreement with study of Culshaw et al (12.2%). 2 Though 362 patients were clinically diagnosed as septicaemia, bacteria or fungi were isolated only in 67 (18.5%) patients. As BIRDEM hospital is the largest tertiary hospital dealing with diabetic patients in Bangladesh, so a large number of patients whose blood samples were positive were suffering from DM (83.5%).…”

The Shift of an Intestinal “Microbiome” to a “Pathobiome” Governs the Course and Outcome of Sepsis Following Surgical Injury

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Antimicrobial Susceptibility and Microorganisms Isolated from Blood Cultures of Hospitalized Patients in Intensive Care Units

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“…Among all microbial growth, 113 (58.55%) were gram-positive bacteria, 69 (35.75%) were gram-negative rods and 11 (5.7%) were fungi. Staphylococcus aureus was the most frequent microorganism (48; 24.87%), followed by coagulasenegative Staphylococci (35;18,13%), Enterococcus spp. (30;15,54%), Stenotrophomonas maltophilia, Escherichia coli, and Pseudomonas spp.…”