The Microbiology of Bloodstream Infection: 20-Year Trends from the SENTRY Antimicrobial Surveillance Program

Diekema, Daniel J.; Hsueh, Po-Ren; Mendes, Rodrigo E.; Pfaller, Michael A.; Rolston, Kenneth V. I.; Sader, Hélio S.; Jones, Ronald N.

doi:10.1128/aac.00355-19

Cited by 342 publications

(276 citation statements)

References 38 publications

Supporting

Mentioning

256

Contrasting

Unclassified

Order By: Relevance

“…E. coli was the most common gram-negative organism causing BSI in our study and it is also implicated as a frequent organism causing BSI in Europe and in the SENTRY surveillance program. 4,18 In our study, the MDRI of A. baumannii complex has been the highest. It exhibited resistance to mostly all the antibiotics, except tigecycline and colistin, which is also reported elsewhere.…”

Section: Discussionmentioning

confidence: 44%

Antimicrobial Susceptibility Trends among Pathogens Isolated from Blood: A 6-Year Retrospective Study from a Tertiary Care Hospital in East Sikkim, India

et al. 2020

View full text Add to dashboard Cite

Background Bloodstream infections (BSIs) are one of the frequent nosocomial infections among hospitalized patients. To understand the local epidemiology and evolving antimicrobial drug resistance of blood-borne pathogens, we analyzed the distribution and antibiotic sensitivity profile of organisms causing BSI in our hospital-based study. Materials and Methods We reviewed retrospective data of laboratory-confirmed BSIs, from January 2013 to December 2018. Causative organisms and their antibiotic susceptibility profile of primary and secondary BSI reports were determined from BacT/Alert and Vitek systems findings (bioMérieux). A 6-year multidrug resistance indexing was done to document the resistance pattern of the commonly isolated organisms. Results A total of 1,340 (10.2%) BSIs were reported from 13,091 blood cultures. Organisms were frequently isolated from the younger population (≤20 years), especially from ages < 1 year (20.8% of total BSIs). Majority of pathogens were bacterial (97.1%) whereas 2.9% were fungal in origin. Monomicrobial growth was recorded in over 98% of BSIs. Gram-positive and gram-negative bacteria isolated were 518 (39.8%) and 783 (60.2%), respectively. Commonly isolated organisms were coagulase-negative Staphylococci (29.4%), Escherichia coli (19.8%), Klebsiella species (13.5%), Salmonella species (9.4%), and Staphylococcus aureus (7.5%). Multidrug-resistance index was observed highest in Acinetobacter species followed by Pseudomonas aeruginosa and S. aureus. Conclusion Overall, there has been a gradual decline in the reporting of BSI. However, infections by gram-negative bacilli and multidrug-resistant organisms remain persistently high. Ages < 20 years were the vulnerable group, with infants < 1 year contributing to the maximum number of BSI cases caused by both bacteria and fungi. Therefore, additional methods are required to study the origin and causation of these infections, particularly among vulnerable patients.

show abstract

Section: Discussionmentioning

confidence: 44%

Antimicrobial Susceptibility Trends among Pathogens Isolated from Blood: A 6-Year Retrospective Study from a Tertiary Care Hospital in East Sikkim, India

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In addition, Enterobacteriaceae accounted for 93.0% of pathogens in patients with community-acquired bacteremia, whereas non-fermenting bacteria accounted for 21.6% of pathogens among hospital-acquired infections. Since previous studies reported that the frequencies of isolated pathogens and drug resistance patterns are different between community-acquired, healthcare-associated, and hospital-acquired bacteremia [9,10], the clinical settings where patients acquire bacteremia should be considered when predicting the causative pathogens and determining the therapeutic strategy.…”

Section: Discussionmentioning

confidence: 99%

Multicenter surveillance of the epidemiology of gram-negative bacteremia in Japan

Kosai

Yamagishi

Hashinaga

et al. 2020

Journal of Infection and Chemotherapy

View full text Add to dashboard Cite

a b s t r a c tThis study investigated the epidemiology of adult patients with bacteremia caused by seven major gramnegative bacteria during a year at four university hospitals in Japan. Of the 438 cases included, Escherichia coli (247 patients) was the most frequently isolated pathogen, followed by Klebsiella species (89 patients), Enterobacter species (31 patients), Pseudomonas aeruginosa (29 patients), Bacteroides species (19 patients), Acinetobacter species (12 patients) and Stenotrophomonas maltophilia (11 patients). The overall, crude in-hospital mortality was 16.4%, ranging from 9.7% with Enterobacter species to 54.5% with S. maltophilia. Community-and hospital-acquired bacteremia accounted for 52.5% and 47.5%, respectively. Enterobacteriaceae were isolated from 93.0% of patients with community-acquired bacteremia, whereas non-fermenting bacteria were isolated from 21.6% of patients with hospital-acquired bacteremia. Of the 423 patients analyzed, 86.8% and 13.2% were monomicrobial and polymicrobial infections, respectively, and their in-hospital mortalities were 13.9% and 30.4%, respectively. Although carbapenemresistant Enterobacteriaceae were not detected, extended-spectrum b-lactamase (ESBL) production was seen in 24.3% of E. coli and 6.7% of Klebsiella species, respectively. E. coli producing ESBL showed high resistance rates to fluoroquinolones (approximately 90%), in contrast to non-producing-E. coli (approximately 21%). The susceptibilities to carbapenems and fluoroquinolones were approximately 80% for P. aeruginosa, whereas all Acinetobacter species were susceptible to these antibiotics. Bacteroides species showed 100% susceptibility to piperacillin/tazobactam and carbapenems, but only 47.4% were susceptible to clindamycin. Further studies, as well as continued surveillance, are required to determine the appropriate therapeutic strategy for gram-negative bacteremia.

show abstract

“…BSI caused by Gram-negative bacteria is of great concern with high rates of antimicrobial resistance [2][3][4]. E. coli is the most frequently isolated Gramnegative bacteria in BSI and is responsible for over 20 % of cases worldwide [5].…”

Section: Introductionmentioning

confidence: 99%

Improving the recovery and detection of bloodstream pathogens from blood culture

Falconer

Hammond

Gillespie

2020

Journal of Medical Microbiology

View full text Add to dashboard Cite

Introduction. Bloodstream infections (BSI) are growing in incidence and present a serious health threat. Most patients wait up to 48 h before microbiological cultures can confirm a diagnosis. Low numbers of circulating bacteria in patients with BSI mean we need to develop new methods and optimize current methods to facilitate efficient recovery of bacteria from the bloodstream. This will allow detection of positive blood cultures in a more clinically useful timeframe. Many bacterial blood recovery methods are available and usually include a combination of techniques such as centrifugation, filtration, serum separation or lysis treatment. Here, we evaluate nine different bacteria recovery methods performed directly from blood culture. Aim. We sought to identify a bacterial recovery method that would allow for a cost-effective and efficient recovery of common BSI pathogens directly from blood culture. Methods. Simulated E. coli ATCC 25922 blood culture was used as a model system to evaluate nine different bacteria recovery methods. Each method was assessed on recovery yield, cost, hands-on time, risk of contamination and ease of use. The highest scoring recovery method was further evaluated using simulated blood cultures spiked with seven of the most frequently occurring bloodstream pathogens. The recovery yield was calculated based on c.f.u. count before and after each recovery method. Independent t-tests were performed to determine if the recovery methods evaluated were significantly different based on c.f.u. ml−1 log recovery. Results. All nine methods evaluated successfully recovered E. coli ATCC 25922 from simulated blood cultures although the bacterial yield differed significantly. The MALDI-TOF intact cell method offered the poorest recovery with a mean loss of 2.94±0.37 log c.f.u. ml−1. In contrast, a method developed by Bio-Rad achieved the greatest bacterial yield with a mean bacteria loss of 0.27±0.013 log c.f.u. ml−1. Overall, a low-speed serum-separation method was demonstrated to be the most efficient method in terms of time, cost and recovery efficiency and successfully recovered seven of the most frequent BSI pathogens with a mean bacteria loss of 0.717±0.18 log c.f.u. ml−1. Conclusion. The efficiency of bacterial recovery can vary significantly between different methods and thereby can have a critical impact on downstream analysis. The low-speed serum-separation method offered a simple and effective means of recovering common BSI pathogens from blood culture and will be further investigated for use in the rapid detection of bacteraemia and susceptibility testing in clinical practice.

show abstract

The Microbiology of Bloodstream Infection: 20-Year Trends from the SENTRY Antimicrobial Surveillance Program

Cited by 342 publications

References 38 publications

Antimicrobial Susceptibility Trends among Pathogens Isolated from Blood: A 6-Year Retrospective Study from a Tertiary Care Hospital in East Sikkim, India

Antimicrobial Susceptibility Trends among Pathogens Isolated from Blood: A 6-Year Retrospective Study from a Tertiary Care Hospital in East Sikkim, India

Multicenter surveillance of the epidemiology of gram-negative bacteremia in Japan

Improving the recovery and detection of bloodstream pathogens from blood culture

Contact Info

Product

Resources

About