Clinical diagnostic accuracy of suspected sources of bacteremia and its effect on mortality

Ruiz‐Giardín, José Manuel; Jiménez, Beatriz C.; Martin, Rosa Maria Alegre; Ortiz, J. L. J.; Arenas, Myrna Hilda Condori; J, San Martin; Cabello, Noemí; Barrios, Ángela; Rejas, D.; Salazar, Marialving Fuentes; Jaquetti, Jerónimo

doi:10.1016/j.ejim.2013.05.010

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…Bacteria isolated from blood are typically the causative agents for a circulatory system infection or a local infection(e.g., the special respiratory system) [6], and they often indicate poor prognosis [7]. Therefore, bacteria isolated from blood are important for physicians and studies on pathogenic bacteria and their resistance to antibiotics have a great practical significance and a high clinical value.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial susceptibility among gram-positive and gram-negative blood-borne pathogens collected between 2012-2016 as part of the Tigecycline Evaluation and Surveillance Trial

Zhang

Meng

et al. 2018

Antimicrob Resist Infect Control

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BackgroundAntimicrobial activity of tigecycline and comparator agents was assessedin vitroagainst 27857 isolates source from blood samples collected between 2012 and 2016 as part of the Tigecycline Evaluation and Surveillance Trial (TEST).MethodsThe broth microdilution methods was used to determine minimum inhibitory concentrations (MIC) of blood-borne isolates according to guildlines of the Clinical and Laboratory Standards Institute (CLSI). Antimicrobial susceptibility breakpoints from CLSI guidelines were used as standards to determine susceptibility against comparator agents, whereas tigecycline breakpoints were provided by the US Food and Drug Administration (FDA).ResultsMore than 91% Enterobacteriaceae isolates, belonging to Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacaeandSerratia marcescens, were susceptible to amikacin, meropenem, and tigecycline. Meropenem resistance was observed in 8% ofK.pneumoniae isolates worldwide. Extended-spectrum β-lactamase (ESBL) was produced in 15.9 and 20.9%E.coli and K.pneumoniaeisolates, respectively. MIC90 of tigecycline against Acinetobacter baumannii was 2 μg/ml. The highest proportion of susceptible A.baumanniiisolates was 70.8% for minocycline. Among P.aeruginose isolates worldwide, 71.1–94.9% were susceptible to six antibiotics. Almost all Staphylococcus aureusisolates were susceptible to linezolid(100%), vancomycin(100%), and tigecycline (99.9%). The proportion of methicillin-resistant S.aureus (MRSA) was 33.0% among S.aureusisolates worldwide; it was highest in Asia with 46.6%, followed by North America and Latin America with 37.7 and 34.2%, respectively. Vancomycin-resistant (VR) isolates represented 1.4% ofEnterococcus faecalis (VR.E.faecalis) and 27.6% of Enterococcus faecium(VR.E.faecium). Highest percentages of VR.E.faeciumwere found in North America and Latin America, with 61.6 and 58.1% of the isolates, respectively. Production of penicillin-resistant Streptococcus pneumoniae(PRSP) represented 9.0% of S. pneumoniae isolates worldwide; the PRSP proportion was 25.8% in Asia, 13.0% in Africa, and 11.8% in Latin America.ConclusionsIn our study, tigecycline was the only antibiotic that was active against over 90% of all major blood-borne pathogens. A global comparison revealed that antimicrobial resistance was higher in Africa, Asia and Latin America than in Europe and North America.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial susceptibility among gram-positive and gram-negative blood-borne pathogens collected between 2012-2016 as part of the Tigecycline Evaluation and Surveillance Trial

Zhang

Meng

et al. 2018

Antimicrob Resist Infect Control

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“…Only few studies have investigated bacteremia of unknown origin (BUO) [8] despite its frequent occurrence at an estimated 8-22% of bacteremia cases [9][10][11]. Studies have pointed towards increased mortality when the origin of bacteremia is unknown/undetermined [12][13][14], underlining the importance of locating the primary site of infection in BUO.…”

Section: Introductionmentioning

confidence: 99%

Clinical value of FDG-PET/CT in bacteremia of unknown origin with catalase-negative gram-positive cocci or Staphylococcus aureus

Brøndserud

Pedersen

Rosenvinge

et al. 2019

Eur J Nucl Med Mol Imaging

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Bacteremia is associated with high mortality, especially when the site of infection is unknown. While conventional imaging usually focuses on specific body parts, FDG-PET/CT visualizes hypermetabolic foci throughout the body. Purpose: To investigate the ability of FDG/PET-CT to detect site of infection and its clinical impact in bacteremia of unknown origin with catalase-negative Gram-positive cocci (excluding pneumococci and enterococci) or Staphylococcus aureus (BUOCSA). Methods: We retrospectively identified 157 patients with 165 episodes of BUOCSA, who subsequently underwent FDG-PET/CT. Data were collected from medical records. Decision regarding important sites of infection in patients with bacteremia was based on the entire patient course and served as reference diagnosis for comparison with FDG-PET/CT findings. FDG-PET/CT was considered to have high clinical impact if it correctly revealed site(s) of infection in areas not assessed by other imaging modalities or if other imaging modalities were negative/equivocal in these areas, or if it established a new clinically relevant diagnosis, and/or led to change in antimicrobial treatment. Results: FDG-PET/CT detected sites of infection in 56.4% of cases and had high clinical impact in 47.3%. It was the first imaging modality to identify sites of infection in 41.1% bacteremia cases, led to change of antimicrobial therapy in 14.7%, and established a new diagnosis unrelated to bacteremia in 9.8%. Detection rate and clinical impact weren't significantly influenced by duration of antimicrobial treatment preceding FDG-PET/CT, days from suspicion of bacteremia to FDG-PET/CT-scan, type of bacteremia, or cancer. Conclusion: FDG-PET/CT appears clinically useful in BUOCSA. Prospective studies are warranted for confirmation.

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“…Pathogenic organisms can enter into the blood that is an important factor for various infections like circulatory system infections and local infections (Ruiz-Giardin et al, 2013). Because of the increasing antibiotic resistance, it becomes indispensable to diagnose and discover adequate treatment against antimicrobial resistance.…”

Section: Discussionmentioning

confidence: 99%

Identification and Antibiotic Susceptibility of Blood Culture Isolates from Rajshahi, Bangladesh

Zerin

Islam

Gulnahar

et al. 2021

JSRMBS

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Purpose: As bloodstream infection is a significant cause of morbidity and mortality, the surveillance study is required to continuously monitor the pattern of infection and antibiotic resistance. Our study aimed to detect the antibiotic susceptibility pattern of bacteria isolated from patients in Rajshahi, Bangladesh. Subjects and Methods: This study was conducted over 2 years from January 2019 to December 2020 with a total of 1,367 suspected hemocultures of inward and outward patients in Rajshahi medical college hospital, Rajshahi, Bangladesh. The standard microbiological methods were used in this study. Results: Out of overall 35% positive growth, 34% and 37% showed blood culture infection in the year 2019 and 2020, respectively. Females (55%) were found higher than males (45%). The patients were the highest in the age group 0-10 years (46%) but the number of infections rapidly decreased in the age 11-20 years (21%) followed by a gradual reduction of infection with the increasing age. All the infections were occurred due to single culture and E. coli was accounted as the most frequent infection (39.09%) followed by Staphylococcus aureus, Candida albican, Klebsiella pneumonia, Staphylococcus epidermidis, Salmonella spp., Streptococcus viridans and Pseudomonas aeruginosa. Higher sensitivity towards Cefepime, and Meropenem was demonstrated by both Gram-negative and Gram-positive bloodborne bacteria. A terrifying scenario was that a great number of those isolates showed resistance towards 4, 6, and more than 6 antibiotics, respectively. Conclusion: Our local work on bacteriological profile and antibiogram might help to rationalize empiric treatment strategies.

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Clinical diagnostic accuracy of suspected sources of bacteremia and its effect on mortality

Cited by 6 publications

References 17 publications

Antimicrobial susceptibility among gram-positive and gram-negative blood-borne pathogens collected between 2012-2016 as part of the Tigecycline Evaluation and Surveillance Trial

Antimicrobial susceptibility among gram-positive and gram-negative blood-borne pathogens collected between 2012-2016 as part of the Tigecycline Evaluation and Surveillance Trial

Clinical value of FDG-PET/CT in bacteremia of unknown origin with catalase-negative gram-positive cocci or Staphylococcus aureus

Identification and Antibiotic Susceptibility of Blood Culture Isolates from Rajshahi, Bangladesh

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