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We evaluated the incidence, outcomes, and causative agents of bloodstream infections (BSI) in Finland during 2004–2018 by using data from the national registries. We identified a total of 173,715 BSIs; annual incidence increased from 150 to 309 cases/100,000 population. BSI incidence rose most sharply among persons >80 years of age. The 1-month case-fatality rate decreased from 13.0% to 12.6%, but the 1-month all-cause mortality rate rose from 20 to 39 deaths/100,000 population. BSIs caused by Escherichia coli increased from 26% to 30% of all BSIs. BSIs caused by multidrug-resistant microbes rose from 0.4% to 2.8%, mostly caused by extended-spectrum β-lactamase-producing E. coli. We observed an increase in community-acquired BSIs, from 67% to 78%. The proportion of patients with severe underlying conditions rose from 14% to 23%. Additional public health and healthcare prevention efforts are needed to curb the increasing trend in community-acquired BSIs and antimicrobial drug–resistant E. coli.

Streptococcus dysgalactiae increasingly is recognized as a pathogen of concern for human health. However, longitudinal surveillance data describing temporal trends of S. dysgalactiae are scarce. We retrospectively identified all β-hemolytic streptococcal bloodstream infections reported in Bergen, in western Norway, during 1999-2021. To explore S. dysgalactiae disease burden in a broader context, we mapped the incidence of all microbial species causing bloodstream infections during 2012-2021. We found S. dysgalactiae incidence rates substantially increased during the study period; by 2021, S. dysgalactiae was the fifth most common pathogen causing bloodstream infections in our region. We noted genotypic shifts and found that the rising trend was related in part to the introduction and expansion of the stG62647 emm-type. S. dysgalactiae is among the most common causes of bloodstream infections in western Norway, and increased surveillance and unambiguous species identification are needed to monitor the disease burden attributable to this pathogen.

Multidrug-resistant (MDR) pathogens are responsible for a substantial burden of morbidity and mortality from neonatal sepsis; however, data on these sepsis-related pathogens among hospitalized neonates in China are not well characterized. In this study, a total of 240 strains were isolated from four Women and Children’s hospitals in Southwest China between 2014 and 2019. Of these included pathogens, 104 (43.33%) were gram-positive bacteria, 129 (53.75%) were gram-negative bacteria, and 7 (2.92%) were fungi. Escherichia coli ( E. coli , 34.01%) and Klebsiella pneumoniae ( K. pneumoniae , 15.35%) were the main pathogen of neonate bacteremia. ST167 were the most prevalent STs in E. coli and ST11 in K. pneumoniae. Our study found that E. coli (62.71%) was the predominate pathogen of early-onset sepsis, among which 64.86% were MDR. Late-onset sepsis was mainly caused by K. pneumoniae (28.31%) and E. coli (24.78%), with showing that 78.33% of these pathogens were MDR. Notably, the prevalence of EO/LO pathogens were quite different from Indian and south of China. Moreover, we found that bla CTX-M (42.06%) was most dominant resistant genes with about a third isolates (31.09%) were positive for bla CTX-M-15 . All the carbapenem-resistant K. pneumoniae were positive for NDM-1. Moreover, late-onset sepsis and antibiotic exposure were significantly associated with MDR infection. Emerging multi-resistant pathogens of sepsis posts a serious threat to neonatal outcomes and emphasizes an urgent need to control their further spread.

The clinical importance of Enterobacter spp. remains unclear because phenotype-based Enterobacter species identification is unreliable. We performed a genomic study on 48 cases of Enterobacter-caused bloodstream infection by using in silico DNA-DNA hybridization to identify precise species. Strains belonged to 12 species; Enterobacter xiangfangensis (n = 21) and an unnamed species (taxon 1, n = 8) were dominant. Most (63.5%) Enterobacter strains (n = 349) with genomes in GenBank from human blood are E. xiangfangensis; taxon 1 (19.8%) was next most common. E. xiangfangensis and taxon 1 were associated with increased deaths (20.7% vs. 15.8%), lengthier hospitalizations (median 31 d vs. 19.5 d), and higher resistance to aztreonam, cefepime, ceftriaxone, piperacillin-tazobactam, and tobramycin. Strains belonged to 37 sequence types (STs); ST171 (E. xiangfangensis) was most common (n = 6). Four ST171 strains belonged to a defined clone. Precise species identification has greater implications for epidemiology and infection control than treatment.

To systematically review the risk of bias and applicability of published prediction models for risk of central line-associated bloodstream infection (CLA-BSI) in hospitalized patients. Systematic review of literature in PubMed, Embase, Web of Science Core Collection, and Scopus up to July 10, 2023. Two authors independently appraised risk models using CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) and assessed their risk of bias and applicability using Prediction model Risk Of Bias ASsessment Tool (PROBAST). Sixteen studies were included, describing 37 models. When studies presented multiple algorithms, we focused on the model that was selected as the best by the study authors. Eventually we appraised 19 models, among which 15 were regression models and four machine learning models. All models were at a high risk of bias, primarily due to inappropriate proxy outcomes, predictors that are unavailable at prediction time in clinical practice, inadequate sample size, negligence of missing data, lack of model validation, and absence of calibration assessment. 18 out of 19 models had a high concern for applicability, one model had unclear concern for applicability due to incomplete reporting. We did not identify a prediction model of potential clinical use. There is a pressing need to develop an applicable model for CLA-BSI. •Nineteen models were evaluated for predicting CLA-BSI for hospitalized patients.•All models were all at high risk of bias.•All models had high or unclear concerns regarding applicability.•A clinically and practically useable model for CLA-BSI prediction is in demand.

The aim of this study was to determine the incidence and predictive factors of catheter-related bloodstream infections (CRBSIs) acquired through a central venous catheter for delivery of home parenteral nutrition (HPN) therapy among a patient population in Thailand. This retrospective review was conducted with adult patients with intestinal failure who received HPN from October 2002 to April 2014, at Ramathibodi Home Parenteral and Enteral Nutrition Referral Center in Bangkok. Seventy-two patients (45.8% male, mean age 56.2 ± 15.7 y) were included in the analysis. Incidence of CRBSIs was 1.47 per 1000 catheter days. Over the 12-y period, there were 21 CRBSIs among 10 patients. There were 26 pathogens isolated from these CRBSIs, mostly coagulase-negative staphylococci. Univariate Poisson regression analysis revealed that the incidence rate ratio of CRBSIs was significantly higher in patients who used an implanted port (compared with tunneled catheter), alcohol-based povidone–iodine solution as disinfectant (compared with 2% chlorhexidine gluconate in 70% isopropyl alcohol), cyclic HPN infusion (compared with continuous HPN), and hospital-based compound HPN formulations (compared with 3-in-1 commercial formulations). Furthermore, longer duration of HPN (>250 d) was associated with CRBSIs. Multivariate analysis revealed that longer duration of HPN, cyclic HPN, and hospital-based compound HPN were significantly associated with CRBSIs. CRBSI is a significant complication in patients receiving long-term HPN. Individualized therapy with a multidisciplinary team in centers with HPN management expertise is required. Careful selection of the catheter type and HPN formulation for each patient is necessary to best meet patient requirements and minimize HPN-related complications. Strict compliance by patients and caregivers with evidence-based instructions together with supervision by well-trained HPN providers is the most effective strategy to prevent CRBSIs. •Catheter-related bloodstream infections (CRBSI) is a serious complication in patients receiving long-term Home Parenteral Nutrition (HPN).•Our retrospective study was aimed to determine the incidence and predictive factors of CRBSI in adult patients with intestinal failure who received HPN from October 2002 to April 2014, at Ramathibodi hospital, Mahidol University, Bangkok, Thailand.•The incidence of CRBSI was 1.47 per 1,000 catheter days, compared favorably with other reports.•Multivariate Poisson regression analysis revealed that longer duration of HPN administration, cyclic PN infusion and hospital-based HPN were significantly associated with CRBSIs.•Individualized therapy using a multidisciplinary team approach in centers with HPN management expertise is required to prevent and reduce the catheter-related complications.

This systematic review and meta-analysis examines the impact of quality improvement interventions on central line–associated bloodstream infections in adult intensive care units. Studies were identified through Medline and manual searches (1995–June 2012). Random-effects meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Meta-regression assessed the impact of bundle/checklist interventions and high baseline rates on intervention effect. Forty-one before–after studies identified an infection rate decrease (OR, 0.39 [95% CI, .33–.46]; P < .001). This effect was more pronounced for trials implementing a bundle or checklist approach (P = .03). Furthermore, meta-analysis of 6 interrupted time series studies revealed an infection rate reduction 3 months postintervention (OR, 0.30 [95% CI, .10–.88]; P = .03). There was no difference in infection rates between studies with low or high baseline rates (P = .18). These results suggest that quality improvement interventions contribute to the prevention of central line–associated bloodstream infections. Implementation of care bundles and checklists appears to yield stronger risk reductions.

Introduction: Bloodstream infection (BSI) is a major contributor to morbidity and mortality in hemodialysis patients. Our objective was to identify pathogens causing BSI, its incidence, and associated risk factors.Methodology: Retrospective positive blood culture data were analyzed from five hemodialysis centers (January 2019 until December 2023) across Saudi Arabia.Results: There were 437 bacteremia episodes in 432 patients, with 405 central line and 367 peripheral samples. The BSI rate was 0.67 per 100 patient months. 375 (85.8%) patients had a Central Venous Catheter (CVC), 27 (6.17%) had an arteriovenous fistula (AVF), 5 (1.14%) had an arteriovenous graft (AVG), and 30 (6.9%) had dual access. The central line-associated bloodstream infection (CLABSI) rate was 1.41 per 100 patient months. Gram-positive organisms in the central line blood culture were 169 (44%), and Gram-negative were 200 (51.81%); 16 (4%) cases were polymicrobial, and there was one case of fungi. In peripheral blood cultures, 158 (48.9%) were Gram-positive and 150 (46.4%) were Gram-negative. The most common pathogens were Staphylococcus aureus, MRSA, and Staphylococcus epidermidisin Gram-positive organisms, and Enterobacter cloacae, Klebsiella pneumoniae, and Pseudomonas aeruginosa in Gram-negative organisms. Three cases of fungal infection occurred during the study period. Two-thirds of patients (68%) required hospital treatment, and in 54% of the cases, there was loss of vascular access. Mortality due to sepsis within 4 weeks occurred in five patients.Conclusions: The risk of BSI in hemodialysis patients is high. Gram-negative pathogens contribute to half of the events. In Saudi Arabia, Gram-negative pathogen incidence is significant, and measures are required to curtail it.

We report a case of Spiroplasma bloodstream infection in a patient in China who developed pulmonary infection, acute respiratory distress syndrome, sepsis, and septic shock after emergency surgery for type A aortic dissection. One organism closely related to Spiroplasma eriocheiris was isolated from blood culture and identified by whole-genome sequencing.

This retrospective study aims to describe the clinico-epidemiological characteristics of bloodstream infections (BSIs) and the risk factors in patients with head and neck cancer (n = 227) treated at the Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital between April 2011 and March 2021. Overall, 23.3% of blood cultures were positive. In the culture-positive group, catheter-related bloodstream infections (CRBSIs) were the most common (38.8%), followed by respiratory tract infections (19.4%), and catheter-associated urinary tract infections (6.0%). Methicillin-resistant Staphylococcus aureus (26.9%), Staphylococcus epidermidis (17.9%), and Pseudomonas aeruginosa (10.4%) infections were common. The most frequent treatment for head and neck cancer was surgery (23.9%), followed by treatment interval or palliative care (19.4%), and single radiotherapy (13.4%). The 30-day mortality rate was significantly higher in the BSI than in the non-BSI group (10.4% vs. 1.8%, respectively). CRBSIs are the most frequent source of BSIs in patients with head and neck cancer. In conclusion, central venous catheters or port insertion should be used for a short period to prevent CRBSIs. The risk of developing BSI should be considered in patients with pneumonia. Understanding the epidemiology of BSIs is crucial for diagnosing, preventing, and controlling infections in patients with head and neck cancer.