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Trends of Bloodstream Infections in a University Hospital During 12 Years

Nazmiye Ülkü Tüzemen
Nazmiye Ülkü Tüzemen
, 
Melda Payaslioğlu
Melda Payaslioğlu
, 
Cüneyt Özakin
Cüneyt Özakin
, 
Beyza Ener
Beyza Ener
 und 
Halis Akalin
Halis Akalin
   | 24. Sept. 2022
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Article Category: Original Paper
Online veröffentlicht: 24. Sept. 2022
Seitenbereich: 443 - 452
Eingereicht: 26. Mai 2022
Akzeptiert: 27. Juli 2022
DOI: https://doi.org/10.33073/pjm-2022-039
Schlüsselwörter
© 2022 Nazmiye Ülkü Tüzemen et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

The most common microorganisms in all positive blood cultures over the 12 years.
The most common microorganisms in all positive blood cultures over the 12 years.

Fig. 2

Frequency of microorganisms within all positive blood cultures over the 12 years. VRE – vancomycin-resistant enterococci, MRSA – methicillin-resistant S. aureus, ESBL – extended-spectrum β-lactamase
Frequency of microorganisms within all positive blood cultures over the 12 years. VRE – vancomycin-resistant enterococci, MRSA – methicillin-resistant S. aureus, ESBL – extended-spectrum β-lactamase

Distribution of microorganisms in bloodstream infections in the wards and intensive care units.

Bloodstream infection episodes Wards n (%) Intensive care units n (%) Overall n (%)
Monomicrobial Gram-negative 3,065 (42.8%) 710 (40.9%) 3,775 (42.5%)
Escherichia coli 971 (13.6%) 57 (3.3%) 1,028 (11.6%)
Klebsiella pneumoniae 529 (7.4%) 146 (8.4%) 675 (7.6%)
Acinetobacter baumannii 261 (3.6%) 186 (10.7%) 447 (5.0%)
Pseudomonas aeruginosa 275 (3.8%) 65 (3.7%) 340 (3.8%)
Gram-positive 2,289 (32.0%) 441 (25.4%) 2,730 (30.7%)
Coagulase-negative staphylococci (717 10%) (10.6184 %) (10.1901 %)
Staphylococcus aureus 717 (10%) 96 (5.5%) 813 (9.1%)
Enterococcus faecalis 188 (2.6%) 57 (3.3%) 245 (2.8%)
Enterococcus faecium 191 (2.7%) 38 (2.2%) 229 (2.6%)
Fungi 559 (7.8%) 106 (6.1%) 665 (7.5%)
Monomicrobial (Total) (5,913 82.7%) (1,257 72.3%) (7,170 80.6%)
Polymicrobial 1,240 (17.3%) 481 (27.7%) 1,721 (19.4%)
Total 7,153 (100%) 1,738 (100%) 8,891 (100%)

Antibiotic resistance rates of the most common Gram-negative bacteria in blood cultures.

Escherichia coli (%) (n= 1,360) P Klebsiella pneumoniae (%) (n= 1,031) P Acinetobacter baumannii (%) (n = 864) P Pseudomonas aeruginosa (%) (n = 580) P
Wards ICU Overall Wards ICU Overall Wards ICU Overall Wards ICU Overall
Ceftriaxone 25.7 23.8 25.6 0.664 38 50.4 41.1 <0.001 38.2 28.5 33.4 0.002 - - - -
Cefotaxime 11.3 23.8 12.3 <0.001 10.7 20.2 13.1 <0.001 32.6 43.5 38 0.001 - - - -
Cefepime 36.9 49.5 37.9 0.010 46.8 67.2 52 <0.001 47.7 62.5 55 <0.001 19.3 38.2 24.8 <0.001
Imipenem 1.4 1 1.3 0.589 25.1 48.9 31.1 <0.001 74.9 88.7 81.7 <0.001 23.9 39.4 28.4 <0.001
Meropenem 0.9 1 0.9 0.620 24.7 48.9 30.8 <0.001 74.7 90.7 82.6 <0.001 17.8 34.1 22.6 <0.001
Ertapenem 2.9 4.8 3.1 0.219 25.6 46.6 30.9 <0.001 76 74.3 75.2 0.558 77.3 77.1 77.2 0.946
Piperacillm- Tazobactam 23.8 25.7 24 0.663 50.5 72.5 56.1 <0.001 50 66.7 58.2 <0.001 15.6 31.2 20.2 <0.001
Amikacin 1.4 1.9 1.4 0.438 5.6 21 9.5 <0.001 70.4 76.2 73.2 0.053 5.4 8.2 6.2 0.265
Gentamicin 26.1 36.2 26.8 0.024 23.3 42.7 28.2 <0.001 62.2 75.2 68.6 <0.001 12.2 26.5 16.4 <0.001
Colistin 0.2 1 0.3 0.275 6 14.1 8.1 <0.001 2.3 1.4 1.8 0.477 0.7 1.2 0.9 0.633
Fosfomycin 0 0 0 - 0.8 1.1 0.9 0.411 1.6 0.9 1.3 0.570 - - - -
Ciprofloxacin 44.6 44.8 44.6 0.978 37.2 69.8 45.5 <0.001 81.2 96.8 88.9 <0.001 11.2 20 13.8 0.008
ESBL 36.6 43.8 37.1 0.086 45.9 56.9 48.7 0.001 - - - - - - - -
Carbapenem- resistant 3.3 4.8 3.5 0.294 29.8 58.4 37.1 <0.001 90.5 93.8 92.1 0.080 83.4 88.2 84.8 0.162

Antibiotic resistance rates of the most common Gram-positive bacteria in blood cultures.

Staphylococcus aureus (%) (n = 996) p Coagulase-negative staphylococci (%) (n = 1,382) p Enterococcus faecalis/ Enterococcus faecium (%) (n = 1,036) p
Wards ICU Overall Wards ICU Overall Wards ICU Overall
Daptomycin 0 0 0 – 0 0 0 – –1 –1 –1 –
Oxacillin 16.6 37.7 19.7 < 0.001 82.9 90.1 84.7 0.001 –1 –1 –1 –
Vancomycin 0 0 0 – 0 0 0 – 10.9 8.1 10.1 0.185
Teicoplanin 0.8 0.7 0.8 0.668 6.5 9 7.1 0.155 10.4 8.1 9.7 0.273
Linezolid 0 0 0 – 0.7 0.6 0.7 0.624 1 1.1 1.1 0.587
Penicillin –1 –1 –1 – –1 –1 –1 – 38.8 26 35.4 < 0.001
High-gentamicin level –2 –2 –2 – –2 –2 –2 – 43.5 48 44.7 0.202
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