The proportion, species distribution and dynamic trends of bloodstream infection cases in a tertiary hospital in China, 2010–2019

Abstract

Background Recent epidemiological studies on bloodstream infection (BSI) that include the proportion, species distribution and dynamic changes are scarce in China. This study was performed to understand these epidemiological data of BSI over the past 10 years in China. Methods Using a prospective nosocomial infection surveillance system, this study was retrospectively performed in one of the largest hospitals in China. The time trend was tested using the Cochran–Armitage trend test in R Programming Language. Results From 2010 to 2019, there were totally 9381 episodes of BSI cases out of 1,437,927 adult-hospitalized patients in the hospital, the total proportion of BSI cases was 6.50‰ (6.50 episodes per 1000 adult-hospitalized patients) and the proportion had significantly decreased (8.24–6.07‰, time trend P < 0.001). Among the 9381 episodes of BSI, 93.1% were bacteremia and others were fungemia (6.9%). As the most common species, the composition ratios of coagulase-negative staphylococcus (25.6–32.5%), Escherichia coli (9.8–13.6%) and Klebsiella pneumoniae (5.3–10.4%) had been dynamically increased (all time trends P < 0.05) and the proportion of Pseudomonas aeruginosa had decreased (4.0–2.4%, time trend P = 0.032). However, Staphylococcus aureus (3.3–3.1%) and Acinetobacter baumannii (4.4–4.2%) had not changed significantly (P > 0.05). These common species were consistent with China Antimicrobial Surveillance Network reported in 2018 (2018 CHINET report), but their composition ratios were different. In addition, among bacteremia, the proportion of multidrug-resistant bacteria gradually increased from 52.9 to 68.4% (time trend P < 0.001). Conclusion The proportion and species distribution of BSI were dynamically changing along certain trends. These trends deserved more attention from clinicians and researchers.

Bloodstream Infections in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

“…Our main finding was that around 7% of hospitalized patients with COVID-19 may experience a BSI. This data was comparable with that measured among hospitalized patients prior to the pandemic [56]. Interestingly, around one out of three patients with COVID-19, once admitted to ICU, may have a clinical course complicated by a BSI.…”

Characterization of the First Carbapenem-Resistant Pseudocitrobacter faecalis Harboring blaOXA-181 in China

“…In this case, neutropenia occurred after high-dose chemotherapy was performed for hematologic malignancy, which significantly impacts the incidence of bloodstream infection in cancer patients [ 21 ]. Furthermore, the patient was suggested to have a hospital-acquired bloodstream infection combined with the course of the disease, which was consistent with previous studies showing that the composition ratio of hospital-acquired bloodstream infections was increasing annually and those related to Enterobacterales also dynamically increasing [ 18 , 22 ].…”

“…Herein, P. faecalis was first found in China and presumptively associated with bloodstream infection. The prevalence of bloodstream infection increased from 2010 to 2019 in China, among which bacteremia occupied a dominant position (93.1%) [ 18 ]. Clinicians attached importance to patients suffering from bloodstream infection, given its high mortality, especially those with high disease severity and inadequate immunologic defenses [ 19 , 20 ].…”

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“…It is of note that the carbapenem resistance rates among the different bacterial isolation sites showed differences, such as the rates for carbapenem-resistant P. aeruginosa (CR-Pae) and carbapenem-resistant A. baumannii in bloodstream infections (BSIs) that were lower than those in respiratory infections ( Cai et al., 2017 ). In China, the proportions of Escherichia coli (9.8%–13.6%) and Klebsiella pneumoniae (5.3%–10.4%) in BSIs increased significantly from 2010 to 2019, while the proportion of P. aeruginosa decreased significantly from 4.0% to 2.4% ( Cui et al., 2021 ). Current evidence revealed that carbapenemase and β-lactamases combined with mutations that decrease permeability were associated with carbapenem resistance ( Queenan and Bush, 2007 ).…”