The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections
Abstract Background The epidemiology of bloodstream infection (BSI) is well-established; however, little is known about the contribution of different pathogens to mortality. To understand true burden of BSI, pathogens contributing to mortality were investigated and compared according to where the BS...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-022-07267-9 |
| _version_ | 1819060911450619904 |
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| author | Seok Jun Mun Si-Ho Kim Hyoung-Tae Kim Chisook Moon Yu Mi Wi |
| author_facet | Seok Jun Mun Si-Ho Kim Hyoung-Tae Kim Chisook Moon Yu Mi Wi |
| author_sort | Seok Jun Mun |
| collection | DOAJ |
| description | Abstract Background The epidemiology of bloodstream infection (BSI) is well-established; however, little is known about the contribution of different pathogens to mortality. To understand true burden of BSI, pathogens contributing to mortality were investigated and compared according to where the BSI was acquired. Methods Data from deceased patients in two teaching hospitals in the Republic of Korea were collected. BSI contributing mortality was defined as BSI within 2-weeks before death. Cases were grouped by acquisition sites: community-acquired (CA)-, healthcare-associated (HCA)-, and hospital-acquired (HA)-BSI. Drug resistance, BSI focus, and appropriateness of empirical antimicrobial therapy were also compared. Results Among 1849 deceased patients in the hospitals, 280 (15.1%) patients experienced BSI within 2-weeks before death. In all, 71, 53, and 156 patients in the CA-, HCA-, and HA-BSI groups, respectively, with 316 total isolated pathogens were analyzed. The three most common pathogens were Klebsiella pneumoniae (17.1%), Escherichia coli (16.4%), and Staphylococcus aureus (11.4%). While K. pneumoniae and E. coli were the most common pathogens in CA- and HCA-BSI, Acinetobacter baumannii and Candida species were in HA-BSI. 26.3% (41/156) of patients experienced breakthrough HCA-BSI during administration of carbapenem and/or vancomycin. The proportion of central venous catheter-related infection (0%, 3.4% and 28.3%), carbapenem resistant-Gram negative bacilli (0%, 6.9% and 21.9%), and inappropriate empirical antimicrobial therapy (21.1%, 37.7% and 51.9%; all P < 0.001) were more frequently observed in HA-BSI. Conclusion The epidemiology of BSI related to mortality had unique characteristics according to the acquisition site. Given the epidemiology of HA-BSI, infection control and antibiotics stewardship programs should be emphasized. |
| first_indexed | 2024-12-21T14:34:31Z |
| format | Article |
| id | doaj.art-a50bc691855048f5a59dc6451c75ff62 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-21T14:34:31Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-a50bc691855048f5a59dc6451c75ff622022-12-21T19:00:22ZengBMCBMC Infectious Diseases1471-23342022-04-012211710.1186/s12879-022-07267-9The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infectionsSeok Jun Mun0Si-Ho Kim1Hyoung-Tae Kim2Chisook Moon3Yu Mi Wi4Division of Infectious Diseases, Department of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik HospitalDivision of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of MedicineDepartment of Laboratory Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of MedicineDivision of Infectious Diseases, Department of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik HospitalDivision of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of MedicineAbstract Background The epidemiology of bloodstream infection (BSI) is well-established; however, little is known about the contribution of different pathogens to mortality. To understand true burden of BSI, pathogens contributing to mortality were investigated and compared according to where the BSI was acquired. Methods Data from deceased patients in two teaching hospitals in the Republic of Korea were collected. BSI contributing mortality was defined as BSI within 2-weeks before death. Cases were grouped by acquisition sites: community-acquired (CA)-, healthcare-associated (HCA)-, and hospital-acquired (HA)-BSI. Drug resistance, BSI focus, and appropriateness of empirical antimicrobial therapy were also compared. Results Among 1849 deceased patients in the hospitals, 280 (15.1%) patients experienced BSI within 2-weeks before death. In all, 71, 53, and 156 patients in the CA-, HCA-, and HA-BSI groups, respectively, with 316 total isolated pathogens were analyzed. The three most common pathogens were Klebsiella pneumoniae (17.1%), Escherichia coli (16.4%), and Staphylococcus aureus (11.4%). While K. pneumoniae and E. coli were the most common pathogens in CA- and HCA-BSI, Acinetobacter baumannii and Candida species were in HA-BSI. 26.3% (41/156) of patients experienced breakthrough HCA-BSI during administration of carbapenem and/or vancomycin. The proportion of central venous catheter-related infection (0%, 3.4% and 28.3%), carbapenem resistant-Gram negative bacilli (0%, 6.9% and 21.9%), and inappropriate empirical antimicrobial therapy (21.1%, 37.7% and 51.9%; all P < 0.001) were more frequently observed in HA-BSI. Conclusion The epidemiology of BSI related to mortality had unique characteristics according to the acquisition site. Given the epidemiology of HA-BSI, infection control and antibiotics stewardship programs should be emphasized.https://doi.org/10.1186/s12879-022-07267-9Bloodstream infectionMortalityHospital-acquired infectionAntimicrobial resistance |
| spellingShingle | Seok Jun Mun Si-Ho Kim Hyoung-Tae Kim Chisook Moon Yu Mi Wi The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections BMC Infectious Diseases Bloodstream infection Mortality Hospital-acquired infection Antimicrobial resistance |
| title | The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections |
| title_full | The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections |
| title_fullStr | The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections |
| title_full_unstemmed | The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections |
| title_short | The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections |
| title_sort | epidemiology of bloodstream infection contributing to mortality the difference between community acquired healthcare associated and hospital acquired infections |
| topic | Bloodstream infection Mortality Hospital-acquired infection Antimicrobial resistance |
| url | https://doi.org/10.1186/s12879-022-07267-9 |
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