Abstract

ABSTRACT Background: Gram-negative bacterial bloodstream infections (BSIs) are associated with high morbidity and mortality. The present study examines the incidence, clinical characteristics, microbiological features, drug resistance and mortality associated with Gram-negative bacterial BSIs at a tertiary-care hospital in Beijing, China. Methods: This retrospective cohort study of patients with Gram-negative bacterial BSIs was performed between 1 January 2010 and 31 December 2018 at the Chinese People,s Liberation Army General Hospital. Results: A total of 6867 episodes of Gram-negative bacterial BSIs occurred among 3199 patients over 9 years. The overall incidence of Gram-negative bacterial BSIs fluctuated from 2.30 to 2.55 episodes per 1000 admissions over 9 years. Escherichia coli was the major pathogen (34.3%). The antibiotic resistance of ESBLs-producing E. coli was higher than non-ESBLs producing E. coli including the majority of antibiotics, but to carbapenems (0.7% VS 5.1%). Between 2010 and 2018, the overall mortality of Gram-negative bacterial BSIs decreased from 11.41% to 9.05% (X2 = 6.95, P = 0.434). Conclusions: Cephalosporins and carbapenem antibiotics were considered as the optimal treatment for patients with Gram-negative bacterial BSIs except for A. baumannii, which was treated according to the drug sensitivity or multidrug combination.

Highlights

  • bloodstream infections (BSIs) are serious diseases associated with high morbidity and mortality, which are difficult to treat and often result in a heavy social and economic burden, and gram-negative bacteria have been reported as the prevalent cause of BSIs in many studies[1, 2, 3, 4]

  • 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%)

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Summary

Introduction

BSIs are serious diseases associated with high morbidity and mortality, which are difficult to treat and often result in a heavy social and economic burden, and gram-negative bacteria have been reported as the prevalent cause of BSIs in many studies[1, 2, 3, 4]. Mortality from CRE infection was reported by the China CRE Network to be as high as 33.5%, and most cases were determined to be caused by carbapenem-resistant E. coli (CREC) and K. pneumoniae (CRKP)[7]. 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

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