Epidemiology and microbiology of Gram-negative bloodstream infections in a tertiary-care hospital in Beijing, China: a 9-year retrospective study

Abstract

Background Gram-negative bacterial bloodstream infections (BSIs) are serious diseases associated with high morbidity and mortality. The following study examines the incidence, clinical characteristics and microbiological features, drug resistance situations and mortality associated with gram-negative BSIs at a large Chinese tertiary-care hospital in Beijing, China. Methods A retrospective cohort study of patients with gram-negative BSIs was performed between January 1, 2010, and December 31, 2018, at the Chinese People ' s Liberation Army General Hospital. The patients' data were collected and included in the reviewing electronic medical records. Results A total of 6867 episodes of gram-negative BSIs occurred among 3199 patients over 9 years, and there were 3032 signi cant BSI episodes 77% of these cases were healthcare-associated, while 23% were community-associated. The overall incidence of gram-negative BSIs uctuated from 2.30 to 2.55 episodes per 1000 admissions over 9 years. Malignancy was the most common comorbidity and indwelling central intravenous catheter was the most common predisposing factor for gram-negative BSI. Escherichia coli were the major pathogen (34.3%), followed by Klebsiella pneumoniae (23.3%) and other bacterial pathogens (9.9%). The resistance rates of Escherichia coli and Klebsiella pneumoniae to penicillins were more than 90%. and the resistance rates of Acinetobacter baumannii to the most antibiotic were more than 70% include the Carbapenem. The resistance of ESBLs-producing Escherichia coli to the most antibiotic was higher than non-ESBLs producing Escherichia coli but to Carbapenems(0.7% VS 5.1%). The rates of Carbapenems resistance of ESBLs-producing Klebsiella pneumoniae and non-ESBLs producing Klebsiella pneumoniae were 32.8% and 8.1%. The rates of Carbapenems resistance of Enterobacter cloacae and Pseudomonas aeruginosa were 1.4% and 27.8% respectively. Between 2010 and 2018, the overall mortality of gram-negative BSIs decreased from 11.41-9.05%(X 2 = 6.95, P = 0.434). Moreover, the mortality in the ICU decreased from 27.03-14.93%(X 2 = 9.61, P = 0.212), while in the general ward uctuated from 8.85-8.13% that without obvious decrease change(X 2 = 9.29, P = 0.232). Conclusions The mortality of gram-negative BSIs have showed downward trends. carbapenem antibiotics is still consider the best treatment for patients with Gram-negative BSIs except Acinetobacter baumannii.

Distribution and Antibiotic Resistance Characteristics of Bacteria Isolated from Blood Culture in a Teaching Hospital in Vietnam During 2014–2021

“…However, the resistance rate of P. aeruginosa to carbapenems in our study was significantly higher than that in these studies. 5,19,23 The data of our study indicated that the majority of the carbapenem-resistant strains of E. coli, K. pneumoniae, A. baumannii, and P. aeruginosa were MDR. Furthermore, the proportion of MDR strains of these four gram-negative bacteria and S. aureus was tremendously high (Table 5).…”

“… 5 A previous study on BSI in Beijing, China, from 2010 to 2018 reported that the resistance rate of K. pneumoniae to carbapenems (26.58%) was moderately higher than that in our study, but the resistance rate of E. coli to carbapenems (2.58%) was substantially lower than that in our study. 23 Notably, there was an upward trend in meropenem-resistant K. pneumoniae isolates from 2018 to 2021 (15.79%–37.84%, P < 0.05) ( Figure 1 ). A previous study indicated that the spread of KPC-producing Enterobacteriaceae contributed to the increase in the isolates of carbapenem-resistant bacteria in Vietnam.…”

Trends of Bloodstream Infections in a University Hospital During 12 Years

“…In a study from China, the incidence of Gram-positive microorganisms in BSI per 1,000 admissions had decreased (Zhu et al 2018). In another study from China, a detected increase in the incidence of Gram-negative microorganisms was not considered statistically significant (Zhu et al 2021). The incidence density increased linearly in a medicalsurgical intensive care unit during 2005-2007 in Turkey (from 3.57 to 9.60 per 1,000 patient-days) (Erdem et al 2009).…”

Risk Factors for a Hospital-Acquired Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infection: A Five-Year Retrospective Study

“… 10 , 11 BSI has become one of the major medical burdens worldwide, 12 the incidence of sepsis and BSI has risen in recent years. 13 The incidence of Gram-negative BSI is increasing 14 , 15 and CRKP BSI can prolong the length of hospitalization and increase patient mortality significantly, 16 , 17 which is an important clinical threat.…”