Population-Based Epidemiology and Microbiology of Community-Onset Bloodstream Infections

Abstract

SUMMARY Bloodstream infection (BSI) is a major cause of infectious disease morbidity and mortality worldwide. While a positive blood culture is mandatory for establishment of the presence of a BSI, there are a number of determinants that must be considered for establishment of this entity. Community-onset BSIs are those that occur in outpatients or are first identified <48 h after admission to hospital, and they may be subclassified further as health care associated, when they occur in patients with significant prior health care exposure, or community associated, in other cases. The most common causes of community-onset BSI include Escherichia coli , Staphylococcus aureus , and Streptococcus pneumoniae . Antimicrobial-resistant organisms, including methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase/metallo-β-lactamase/carbapenemase-producing Enterobacteriaceae , have emerged as important etiologies of community-onset BSI.

Epidemiology of antimicrobial resistance in bloodstream infections

“…Its prevalence in the Western World ranges between 10 and 20 per 100.000 population. 28 Only 10% of cases are related with healthcare associated infections. 45 One of the important aspects of invasive pneumococcal infections related with bacteremia is that the universal use of conjugate pneumococcal vaccine in infants and more recently in the adult population: Decreased exposure from infants led the adult population have a lower incidence of invasive pneumococcal disease which is also described as herd protection.…”

“…29 Community-acquired MRSA infections have emerged as a global problem since the turn of the 21 st century. [30][31][32] Five major clones are found to be associated with most of the CA-MRSA infections worldwide including multilocus sequence type 1 (ST-1)/USA400 and ST-8/USA300 dominantly found in North America, ST-59 observed in South East Asia, ST-80 observed in Europe and ST-30 distributed worldwide 28 . The clonal structure remains to be determined in CAESAR countries.…”

“…28 It has been estimated that in the Western countries, the incidence of CA-BSIs due to SA is approximately 15 per 100.000 and a mortality rate of 3 per 100.000. 29 Community-acquired MRSA infections have emerged as a global problem since the turn of the 21 st century.…”

IL-22 controls iron-dependent nutritional immunity against systemic bacterial infections

“…E. coli , a Gram-negative bacterium that normally inhabits the intestine, is a major cause of bacteremia and sepsis in humans (28, 29) . As it was observed with C. rodentium , hemin promoted robust colony formation of an E. coli strain isolated from the mouse intestine which was inhibited by HPX in vitro (Fig.…”

U.S. bans antibiotics use for enhancing growth in livestock

“…Enterobacteriaceae found in livestock and on retail meat include the opportunistic pathogens Escherichia coli and Klebsiella (Davis and Price, 2016;Davis et al, 2015;Nordstrom et al, 2013), which are the most common causes of urinary tract infections and among the most common causes of bloodstream infections in patients (Davis and Price, 2016;Diekema et al, 2003;Laupland and Church, 2014;Laupland et al, 2007;Russo and Johnson, 2003;Wisplinghoff et al, 2004). Staphylococcus aureus, the most common cause of skin infections and second most common cause of bloodstream infections in patients (Brook and Frazier, 1995;Carratala et al, 2003;Diekema et al, 2001;Sigurdsson and Gudmundsson, 1989;Wisplinghoff et al, 2003a;Wisplinghoff et al, 2003b;Wisplinghoff et al, 2004), is also found on the skin of livestock and on retail meat (Smith, 2015;Smith and Wardyn, 2015).…”