Douglas Nicholas M, Hennessy Jann N, Currie Bart J, Baird Rob W
Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Territory Pathology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Open Forum Infect Dis. 2020 Oct 17;7(11):ofaa472. doi: 10.1093/ofid/ofaa472. eCollection 2020 Nov.
Information on the local distribution of bloodstream pathogens helps to guide empiric antibiotic selection and can generate hypotheses regarding the effectiveness of infection prevention practices. We assessed trends in bacterial blood culture isolates at Royal Darwin Hospital (RDH) in the Northern Territory of Australia between 1999 and 2019.
Species identification was extracted for all blood cultures first registered at RDH. Thirteen organisms were selected for focused analysis. Trends were examined graphically and using univariable linear regression.
Between 1999 and 2019, 189 577 blood cultures from 65 276 patients were processed at RDH. Overall, 6.72% (12 747/189 577) of blood cultures contained a bacterial pathogen. was the most common cause of bacteremia during the first decade, with an estimated incidence of 96.6 episodes per 100 000 person-years (py; 95% CI, 72.2-121/100 000 py) in 1999. Since 2009, bacteremia has declined markedly, whereas there has been an inexorable rise in bacteremia (30.1 to 74.7/100 000 py between 1999 and 2019; < .001), particularly in older adults. Since 2017, has been more common than . Rates of bacteremia have reduced dramatically in children, while remained the fourth most common bloodstream isolate overall.
The incidence of bacteremia, though high by international standards, is declining at RDH, possibly in part due to a sustained focus on both community and hospital infection prevention practices. Gram-negative bacteremia, particularly due to , is becoming more common, and the trend will likely continue given our aging population.
血流病原体的局部分布信息有助于指导经验性抗生素选择，并能就感染预防措施的有效性提出假设。我们评估了1999年至2019年间澳大利亚北领地皇家达尔文医院（RDH）细菌血培养分离株的趋势。
提取在RDH首次登记的所有血培养的菌种鉴定信息。选择13种微生物进行重点分析。通过图表和单变量线性回归分析趋势。
1999年至2019年间，RDH对65276名患者的189577份血培养进行了处理。总体而言，6.72%（12747/189577）的血培养含有细菌病原体。在第一个十年中，[具体细菌名称1]是菌血症最常见的病因，1999年估计发病率为每10万人年96.6例（95%CI，72.2 - 121/10万人口年）。自2009年以来，[具体细菌名称1]菌血症显著下降，而[具体细菌名称2]菌血症却持续上升（1999年至2019年间从30.1/10万人口年升至74.7/10万人口年；P <.001），尤其是在老年人中。自2017年以来，[具体细菌名称2]比[具体细菌名称1]更常见。儿童[具体细菌名称3]菌血症发病率大幅下降，而[具体细菌名称3]总体上仍是第四常见的血流分离菌。
按国际标准，[具体细菌名称1]菌血症发病率虽高，但在RDH呈下降趋势，这可能部分归因于对社区和医院感染预防措施的持续关注。革兰氏阴性菌血症，尤其是由[具体细菌名称2]引起的，正变得越来越普遍，鉴于我们人口老龄化的现状，这一趋势可能会持续下去。
