Microbiological Analysis and Mortality Risk Factors in Patients with Polymicrobial Bloodstream Infections

Abstract

Purpose To study the etiological characteristics and risk factors affecting the prognosis of patients with polymicrobial bloodstream infections. Patients and Methods Overall, 141 patients with polymicrobial bloodstream infections in Henan Provincial People’s Hospital during 2021 were included. Laboratory test indexes, department of admission, sex, age, intensive care unit (ICU) admission, surgical history, and central venous catheter placement were collected. Patients were divided into surviving and deceased groups based on outcomes at discharge. Mortality risk factors were identified by univariate and multivariable analyses. Results Seventy-two of 141 patients survived. Patients were mainly from the ICU and the Departments of Hepatobiliary Surgery and Hematology. Overall, 312 microbial strains were detected: 119 gram-positive, 152 gram-negative, and 13 anaerobic bacteria and 28 fungi. Among the gram-positive bacteria, coagulase-negative staphylococci were most frequent (44/119, 37%), followed by enterococci (35/119, 29.4%). Among coagulase-negative staphylococci, methicillin-resistant coagulase-negative staphylococci incidence was 75% (33/44). Among gram-negative bacteria, Klebsiella pneumoniae was most common (45/152, 29.6%), followed by Escherichia coli (25/152, 16.4%) and Pseudomonas aeruginosa (13/152, 8.6%). Among K. pneumoniae , the incidence of carbapenem-resistant (CR) K. pneumoniae was 45.7% (21/45). On univariate analysis, mortality risk factors included increased white blood cells and C-reactive protein, decreased total protein and albumin, CR strains, ICU admission, central venous catheter, multiple organ failure, sepsis, shock, pulmonary diseases, respiratory failure, central nervous system diseases, cardiovascular diseases, hypoproteinemia, and electrolyte disturbances (P < 0.05). Multivariable analysis showed that ICU admission, shock, electrolyte disorders, and central nervous system diseases were independent mortality risk factors. The survival curve shows that the survival rate of patients with polymicrobial CR bloodstream infections was lower than that of patients with polymicrobial non-CR bloodstream infections (P=0.029). Conclusion Patients with polymicrobial bloodstream infections are typically critically ill and harbor multidrug-resistant bacteria. Thus, to minimize mortality rate in critically ill patients, changes in infectious flora should be monitored, antibiotics selected reasonably, and invasive procedures reduced.

Polymicrobial bloodstream infections a risk factor for mortality in neonates at the national hospital, Tanzania: A case-control study

“…We also found that patients with polymicrobial BSIs had a longer median length of hospital stay than patients with monomicrobial BSIs, but the differences were not statistically significant. A similar finding has been reported from previous studies, which found polymicrobial BSIs increase the risk of mortality [ 11 , 15 ]. The difficulties in selecting appropriate empiric antimicrobials targeting multiple pathogens and delays in reporting blood culture results could impact our study’s observed findings.…”

Parasite and bacterial co-infections with Leishmania spp. in dogs

“…In human, bloodstream polymicrobial infections often occur in patients with poor medical conditions (XU et al, 2023). The risk factors for these infections include diabetes, chronic liver diseases, cardio vascular diseases, immunosuppressive diseases, hematologic diseases, and tumors (XU et al, 2023). In our study, blood coinfection was identified among the canines with or without Leishmania infection, and many dogs showed poor health and nutritional conditions.…”

“…In fact, many infectious diseases of hu mans and animals are caused by more than one microorganism from different kingdoms, gene ra, species, and by phenotypic variants of a sin gle species (Bakaletz, 2004). In human, bloodstream polymicrobial infections often occur in patients with poor medical conditions (XU et al, 2023). The risk factors for these infections include diabetes, chronic liver diseases, cardio vascular diseases, immunosuppressive diseases, hematologic diseases, and tumors (XU et al, 2023).…”

In Vitro Antibacterial Activity of Ceftobiprole and Comparator Compounds against Nation-Wide Bloodstream Isolates and Different Sequence Types of MRSA

“…Studies have demonstrated that one-third of hospital-associated deaths were related to sepsis, and bacterial infections causing sepsis account for 87% of hospitalizations [1]. Xu et al found that among 1318 patients with positive blood cultures in China, the associated mortality rate was 48.9% [2]. The GBD 2019 Antimicrobial Resistance Collaborators estimated that deaths caused by 33 bacterial pathogens accounted for 13.6% of all global deaths and 56.2% of all sepsis-related deaths in 2019 [3].…”

“…For ceftobiprole, almost no activity was observed against ESBL-positive Enterobacterales, with resistance rates ranging from 78.6% to 100.0% (Table 3). 2 MIC 50 : minimum inhibitory concentration that inhibits 50% of bacterial isolates tested. 3 MIC 90 : minimum inhibitory concentration that inhibits 90% of bacterial isolates tested.…”