八种哨兵细菌引起的医院获得性血流感染：2018 - 2019年以色列全国性研究 - Suppr

Hospital-Onset Bloodstream Infections Caused by Eight Sentinel Bacteria: A Nationwide Study in Israel, 2018-2019.

作者信息

Nutman Amir, Wullfhart Liat, Temkin Elizabeth, Feldman Sarah F, Schechner Vered, Schwaber Mitchell J, Carmeli Yehuda

机构信息

National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

出版信息

Microorganisms. 2022 May 11;10(5):1009. doi: 10.3390/microorganisms10051009.

Nationwide studies on hospital-onset bloodstream infections (HO-BSIs) are scarce. To describe incidence, mortality and antimicrobial resistance (AMR) of HO-BSI caused by eight sentinel bacteria in Israel, we used laboratory-based BSI surveillance data from 1 January 2018 to 31 December 2019. All hospitals reported positive blood cultures growing , , , , , , and . We calculated HO-BSI incidence and 14-day, 30-day and 1-year mortality in adults. We performed multivariable logistic regression to identify predictors of 30-day mortality. The study included 6752 HO-BSI events: (1659, 22.1%), (1491, 19.8%), (1315, 17.5%), (1175, 15.6%), (778, 10.4%), (654, 8.7%), (405, 5.4%) and (43, 0.6%). Overall incidence was 2.84/1000 admissions (95% CI: 2.77-2.91) and 6.88/10,000 patient-days (95% CI: 6.72-7.05). AMR isolates accounted for 44.2% of events. Fourteen-day, thirty-day and one-year mortality were 30.6% (95% CI: 28.5%-32.8%), 40.2% (95% CI: 38.2%-42.1%) and 66.5% (95% CI: 64.7%-68.3%), respectively. Organisms with highest risk for 30-day mortality (compared with ) were (OR 2.85; 95% CI: 2.3-3.55), (OR 2.16; 95% CI: 1.66-2.79) and (OR 2.36; 95% CI: 1.21-4.59). Mortality was higher in AMR isolates (OR 1.57; 95% CI: 1.4-1.77). This study highlights the incidence, associated high mortality and important role of antibiotic resistance in HO-BSI.

关于医院获得性血流感染（HO-BSIs）的全国性研究很少。为了描述以色列由八种哨兵细菌引起的HO-BSI的发病率、死亡率和抗菌药物耐药性（AMR），我们使用了2018年1月1日至2019年12月31日基于实验室的BSI监测数据。所有医院报告血培养阳性，培养出、、、、、、和。我们计算了成人HO-BSI的发病率以及14天、30天和1年的死亡率。我们进行了多变量逻辑回归以确定30天死亡率的预测因素。该研究包括6752例HO-BSI事件：（1659例，22.1%）、（1491例，19.8%）、（1315例，17.5%）、（1175例，15.6%）、（778例，10.4%）、（654例，8.7%）、（405例，5.4%）和（43例，0.6%）。总体发病率为2.84/1000次住院（95%置信区间：2.77 - 2.91）和6.88/10000患者日（95%置信区间：6.72 - 7.05）。AMR分离株占事件的44.2%。14天、30天和1年的死亡率分别为30.6%（95%置信区间：28.5% - 32.8%）、40.2%（95%置信区间：38.2% - 42.1%）和66.5%（95%置信区间：64.7% - 68.3%）。30天死亡率风险最高的微生物（与相比）是（比值比2.85；95%置信区间：2.3 - 3.55）、（比值比2.16；95%置信区间：1.66 - 2.79）和（比值比2.36；95%置信区间：1.21 - 4.59）。AMR分离株的死亡率更高（比值比1.57；95%置信区间：1.4 - 1.77）。这项研究突出了HO-BSI的发病率、相关的高死亡率以及抗生素耐药性的重要作用。