Piekiełko Piotr, Hareza Dariusz A, Stawowczyk Ewa, Jachowicz-Matczak Estera, Wójkowska-Mach Jadwiga
Department of Internal Diseases, Centre of Pulmonology and Thoracic Surgery in Bystra, Juliana Fałata 2, Bystra, 43-360, Poland.
Department of Rapid Pulmonary Diagnostics, Centre of Pulmonology and Thoracic Surgery in Bystra, Juliana Fałata 2, Bystra, 43-360, Poland.
Pharmacol Rep. 2025 Jun 19. doi: 10.1007/s43440-025-00753-2.
Bloodstream infection (BSI), defined as bacteraemia accompanied by sepsis or septic shock, is a frequent cause of hospitalization in departments of internal medicine (DIM). This study aimed to characterize the epidemiology, microbiological profile, and antibiotic treatment patterns of BSIs in a DIM setting in 2021-2023 in Polish hospital.
A three-year, single-centre retrospective analysis was conducted at a DIM in Southern Poland. Medical records from 2021 to 2023 were reviewed for patients diagnosed with sepsis (ICD-10 codes A40-A41) with microbiological confirmation. Antibiotic use was assessed using Days of Therapy (DOT) and Length of Therapy (LOT). Empiric and targeted therapies were classified according to the WHO AWaRe (Access, Watch, Reserve) framework.
A total of 124 BSI cases were identified, with an incidence rate of 5.8%. Community-acquired BSIs accounted for 84.3% of cases, while 15.7% were hospital-acquired. The predominant pathogens were Escherichia coli and Staphylococcus aureus. The median LOT for empiric therapy was 3 days (IQR 2-4), with third-generation cephalosporins being the most frequently used agents (78 patients; 43.3%, 228 DOTs; 43.9%). Targeted therapy had a median LOT of 8 days (IQR 5-10), most commonly involving penicillins (33 patients; 28.4%, 291 DOTs; 34.5%). Access group antibiotics were significantly more prevalent in targeted therapy compared to empiric therapy (p < 0.001).
Microbiological confirmation of BSI facilitates a safe de-escalation from broad-spectrum empiric antibiotics to narrow-spectrum targeted therapy, supporting antimicrobial stewardship in internal medicine settings.
血流感染（BSI）定义为伴有脓毒症或脓毒性休克的菌血症，是内科病房（DIM）住院的常见原因。本研究旨在描述2021年至2023年波兰一家医院内科病房环境中血流感染的流行病学、微生物学特征及抗生素治疗模式。
在波兰南部的一家内科病房进行了为期三年的单中心回顾性分析。回顾了2021年至2023年确诊为脓毒症（国际疾病分类第十版编码A40 - A41）且有微生物学确诊的患者的病历。使用治疗天数（DOT）和治疗时长（LOT）评估抗生素使用情况。经验性和靶向性治疗根据世界卫生组织的AWaRe（可及、观察、储备）框架进行分类。
共识别出124例血流感染病例，发病率为5.8%。社区获得性血流感染占病例的84.3%，而医院获得性占15.7%。主要病原体为大肠埃希菌和金黄色葡萄球菌。经验性治疗的中位治疗时长为3天（四分位间距2 - 4），第三代头孢菌素是最常用的药物（78例患者；43.3%，228个治疗天数；43.9%）。靶向性治疗的中位治疗时长为8天（四分位间距5 - 10），最常涉及青霉素（33例患者；28.4%，291个治疗天数；34.5%）。与经验性治疗相比，靶向性治疗中可及组抗生素的使用显著更为普遍（p < 0.001）。
血流感染的微生物学确诊有助于从广谱经验性抗生素安全降级为窄谱靶向性治疗，支持内科环境中的抗菌药物管理。
