Pérez-Crespo Pedro María Martínez, Lanz-García Joaquín Felipe, Bravo-Ferrer José, Cantón-Bulnes María Luisa, Sousa Domínguez Adrian, Goikoetxea Aguirre Josune, Reguera-Iglesias José María, León Jiménez Eva, Armiñanzas Castillo Carlos, Mantecón Vallejo María Ángeles, Marrodan Ciordia Teresa, Fernández Suárez Jonathan, Boix-Palop Lucía, Cuquet Pedragosa Jordi, Jover Saenz Alfredo, Sevilla Blanco Juan, Galán-Sánchez Fátima, Natera Kindelán Clara, Del Arco Jiménez Alfonso, Bahamonde-Carrasco Alberto, Smithson Amat Alejandro, Vinuesa García David, Herrero Rodríguez Carmen, Reche Molina Isabel María, Pérez Camacho Inés, Sánchez-Porto Antonio, Guzmán García Marcos, Becerril Carral Berta, Merino de Lucas Esperanza, López-Hernández Inmaculada, Rodríguez-Baño Jesús, López-Cortés Luis Eduardo
Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena/Departamento de Medicina, Universidad de Sevilla/Instituto de Biomedicina de Sevilla, Seville, Spain; Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario Nuestra Señora de Valme, Seville, Spain.
Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena/Departamento de Medicina, Universidad de Sevilla/Instituto de Biomedicina de Sevilla, Seville, Spain.
Int J Antimicrob Agents. 2021 Jul;58(1):106352. doi: 10.1016/j.ijantimicag.2021.106352. Epub 2021 May 4.
The epidemiology of bloodstream infections (BSIs) is dynamic as it depends on microbiological, host and healthcare system factors. The aim of this study was to update the information regarding the epidemiology of BSIs in Spain considering the type of acquisition. An observational, prospective cohort study in 26 Spanish hospitals from October 2016 through March 2017 including all episodes of BSI in adults was performed. Bivariate analyses stratified by type of acquisition were performed. Multivariate analyses were performed by logistic regression. Overall, 6345 BSI episodes were included; 2510 (39.8%) were community-acquired (CA), 1661 (26.3%) were healthcare-associated (HCA) and 2056 (32.6%) hospital-acquired (HA). The 30-day mortality rates were 11.6%, 19.5% and 22.0%, respectively. The median age of patients was 71 years (interquartile range 60-81 years) and 3656 (58.3%; 95% confidence interval 57.1-59.6%) occurred in males. The proportions according to patient sex varied according to age strata. Escherichia coli (43.8%), Klebsiella spp. (8.9%), Staphylococcus aureus (8.9%) and coagulase-negative staphylococci (7.4%) were the most frequent pathogens. Multivariate analyses confirmed important differences between CA and HCA episodes, but also between HCA and HA episodes, in demographics, underlying conditions and aetiology. In conclusion, we have updated the epidemiological information regarding patients' profiles, underlying conditions, frequency of acquisition types and aetiological agents of BSI in Spain. HCA is confirmed as a distinct type of acquisition.
血流感染（BSIs）的流行病学具有动态性，因为它取决于微生物学、宿主和医疗系统等因素。本研究的目的是根据感染获得类型，更新西班牙血流感染流行病学的相关信息。在2016年10月至2017年3月期间，对西班牙26家医院进行了一项观察性前瞻性队列研究，纳入了所有成人血流感染病例。对按感染获得类型分层的双变量分析进行了。通过逻辑回归进行多变量分析。总体而言，共纳入6345例血流感染病例；2510例（39.8%）为社区获得性（CA），1661例（26.3%）为医疗保健相关（HCA），2056例（32.6%）为医院获得性（HA）。30天死亡率分别为11.6%、19.5%和22.0%。患者的中位年龄为71岁（四分位间距60 - 81岁），男性发生3656例（58.3%；95%置信区间57.1 - 59.6%）。按患者性别划分的比例因年龄层而异。大肠埃希菌（43.8%）、克雷伯菌属（8.9%）、金黄色葡萄球菌（8.9%）和凝固酶阴性葡萄球菌（7.4%）是最常见的病原体。多变量分析证实，在人口统计学、基础疾病和病因方面，社区获得性与医疗保健相关感染病例之间以及医疗保健相关与医院获得性感染病例之间存在重要差异。总之，我们更新了西班牙血流感染患者特征、基础疾病、感染获得类型频率和病原体的流行病学信息。医疗保健相关感染被确认为一种独特的感染获得类型。
