Abstract
BackgroundRecent epidemiological studies on bloodstream infection (BSI) that include the proportion, species distribution and dynamic changes are scarce in China. This study was performed to understand these epidemiological data of BSI over the past 10 years in China.MethodsUsing a prospective nosocomial infection surveillance system, this study was retrospectively performed in one of the largest hospitals in China. The time trend was tested using the Cochran–Armitage trend test in R Programming Language.ResultsFrom 2010 to 2019, there were totally 9381 episodes of BSI cases out of 1,437,927 adult-hospitalized patients in the hospital, the total proportion of BSI cases was 6.50‰ (6.50 episodes per 1000 adult-hospitalized patients) and the proportion had significantly decreased (8.24–6.07‰, time trend P < 0.001). Among the 9381 episodes of BSI, 93.1% were bacteremia and others were fungemia (6.9%). As the most common species, the composition ratios of coagulase-negative staphylococcus (25.6–32.5%), Escherichia coli (9.8–13.6%) and Klebsiella pneumoniae (5.3–10.4%) had been dynamically increased (all time trends P < 0.05) and the proportion of Pseudomonas aeruginosa had decreased (4.0–2.4%, time trend P = 0.032). However, Staphylococcus aureus (3.3–3.1%) and Acinetobacter baumannii (4.4–4.2%) had not changed significantly (P > 0.05). These common species were consistent with China Antimicrobial Surveillance Network reported in 2018 (2018 CHINET report), but their composition ratios were different. In addition, among bacteremia, the proportion of multidrug-resistant bacteria gradually increased from 52.9 to 68.4% (time trend P < 0.001).ConclusionThe proportion and species distribution of BSI were dynamically changing along certain trends. These trends deserved more attention from clinicians and researchers.
Highlights
Bloodstream infection (BSI) refers to various pathogenic microorganisms that have invaded the blood, primarily bacteria and fungi [1]
The dynamic changes in species distribution and antimicrobial susceptibility are important clinical evidence for early empirical antimicrobial therapy of BSI, and these factors were the emphasis of the present study
With the assistance of the highly sensitive and specific prospective real-time nosocomial infection surveillance system (RT-NISS) in our hospital, we identified 9381 episodes of BSI out of 1,437,927 adult-hospitalized patients over 10 years in Chinese People’s Liberation Army General Hospital (CPLAGH), and we found that the total number of adult-hospitalized patients over two consecutive years increased from 2010–2011 to 2018–2019 (211,546 to 359,547 patients every 2 years) and that the corresponding number of the episodes of BSI increased from 1743 to 2184 episodes every 2 years
Summary
Bloodstream infection (BSI) refers to various pathogenic microorganisms that have invaded the blood, primarily bacteria and fungi [1]. Recent epidemiological studies on bloodstream infection (BSI) that include the proportion, species distribution and dynamic changes are scarce in China. As the most common species, the composition ratios of coagulase-negative staphylococcus (25.6–32.5%), Escherichia coli (9.8–13.6%) and Klebsiella pneumoniae (5.3–10.4%) had been dynamically increased (all time trends P < 0.05) and the proportion of Pseudomonas aeruginosa had decreased (4.0–2.4%, time trend P = 0.032). Staphylococcus aureus (3.3–3.1%) and Acinetobacter baumannii (4.4–4.2%) had not changed significantly (P > 0.05) These common species were consistent with China Antimicrobial Surveillance Network reported in 2018 (2018 CHINET report), but their composition ratios were different. Conclusion The proportion and species distribution of BSI were dynamically changing along certain trends. These trends deserved more attention from clinicians and researchers
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