Journal Article

A multicenter investigation of 2,773 cases of bloodstream infections based on China antimicrobial surveillance network (CHINET)

Hu, Yunjian, Ni, Yuxing, Hu, Fupin, Chen, Zhongju, Shan, Bin, Yu, Yunsong, Ai, Xiaoman, Du, Yan, Zhang, Yingyuan, Yang, Yang, Zhang, Yibo, Xu, Yuanhong, Xu, Yingchun, Sun, Ziyong, Wang, Chuanqing, He, Leiyan, Lin, Dongfang, Zhu, Demei, Su, Danhong, Lin, Jie, Zhang, Xiaojiang, Zhuo, Chao, Huang, Ying, Yuan, Lili

2022

Overview

Bloodstream infections (BSIs), especially hospital-acquired BSIs, are a major cause of morbidity and mortality. However, the details about the pathogens and antimicrobial resistance profile of BSIs across China are still lacking. An investigation was conducted in 10 large teaching hospitals from seven geographic regions across China in 2016 based on China Antimicrobial Surveillance Network (CHINET) to profile the clinical and etiological features of BSIs. A total of 2,773 cases of BSIs were identified, a majority (97.3%) of which were monomicrobial. Overall, 38.4% (1,065/2,773) were community-acquired BSIs (CABSIs), and 61.6% (1,708/2,773) were hospital-acquired BSIs (HABSIs). Of the 2,861 pathogenic BSI isolates, 67.5% were Gram-negative bacteria, 29.6% were Gram-positive bacteria, and 2.9% were fungi. The top BSI pathogens were , , coagulase-negative (CNS), , , and . and isolates showed low susceptibility to penicillins, cephalosporins (except ceftazidime and cefepime), and ampicillin-sulbactam (13.1%-43.4% susceptible); moderate susceptibility (about 60% susceptible) to ceftazidime, cefepime, and aztreonam; and high susceptibility (>90%) to β-lactam/β-lactamase inhibitor combinations other than ampicillin-sulbactam, except strains to piperacillin-tazobactam (59.2% susceptible). HABSIs were associated with significantly higher prevalence of carbapenem-resistant and extended-spectrum β-lactamases-producing , methicillin-resistant , methicillin-resistant CNS, and ampicillin-resistant than CABSIs. Overall, 42.0% of the BSI due to strains were resistant to methicillin. The findings about BSIs in teaching hospitals across China add more scientific evidence to inform the appropriate management of the disease.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: Ampicillin / Anti-Bacterial Agents - pharmacology / Anti-Bacterial Agents - therapeutic use / Anti-Infective Agents - pharmacology / Antibiotics / Antimicrobial agents / Antimicrobial resistance / antimicrobial susceptibility testing / Aztreonam / Bacteremia - microbiology / Bacteria / Bacterial infections / bloodstream infection / Carbapenems / Catheters / Cefepime / Ceftazidime / Cellular and Infection Microbiology / Cephalosporins / China - epidemiology / Coagulase / community-acquired / Cross Infection - epidemiology / Cross Infection - microbiology / Drug resistance / Drug Resistance, Bacterial / E coli / Emergency medical care / Escherichia coli / Gram-negative bacteria / Gram-positive bacteria / Hematological diseases / hospital-acquired / Hospitals / Humans / Infectious diseases / Intensive care / Laboratories / Methicillin / Methicillin-Resistant Staphylococcus aureus / Microbial Sensitivity Tests / Morbidity / multicenter investigation / Pathogens / Patients / Piperacillin-tazobactam / Sepsis - drug therapy / Software / Staphylococcus / Staphylococcus aureus / Strains (organisms) / Sulbactam / β Lactamase / β-Lactam antibiotics