Gram-negative bloodstream infections in six German university hospitals, 2016-2020: clinical and microbiological features

被引：0

作者：

Mischnik, Alexander ^{[1
,2
,3
]}

Baltus, Hannah ^{[4
]}

Walker, Sarah V. ^{[1
,5
,6
]}

Behnke, Michael ^{[1
,7
,8
,9
]}

Gladstone, Beryl Primrose ^{[1
,10
]}

Chakraborty, Trinad ^{[1
,11
]}

Falgenhauer, Linda ^{[1
,12
]}

Gastmeier, Petra ^{[1
,7
,8
,9
]}

Goelz, Hanna ^{[1
,13
]}

Goepel, Siri ^{[1
,7
,8
,9
]}

Haecker, Georg A. ^{[1
,13
]}

Higgins, Paul G. ^{[1
]}

Imirzalioglu, Can ^{[1
]}

Kaeding, Nadja ^{[1
,3
]}

Kramme, Evelyn ^{[1
,3
]}

Peter, Silke ^{[1
,14
]}

Rieg, Siegbert ^{[1
]}

Rohde, Anna M. ^{[1
,7
,8
,9
]}

Seifert, Harald ^{[1
,5
,15
]}

Tacconelli, Evelina ^{[1
,8
,9
]}

Tobys, David ^{[1
,5
]}

Trauth, Janina ^{[1
,16
]}

Vehreschild, Maria J. G. T. ^{[1
,17
,18
]}

Xanthopoulou, Kyriaki ^{[1
,5
]}

Rupp, Jan ^{[1
]}

Kern, Winfried V. ^{[1
]}

机构：

[1] German Ctr Infect Res DZIF, Braunschweig, Germany

[2] Univ Med Ctr Freiburg, Div Infect Dis, Dept Med 2, Freiburg, Germany

[3] Univ Hosp Schleswig Holstein, Dept Infect Dis & Microbiol, Campus Lubeck, Lubeck, Germany

[4] Univ Lubeck, Inst Social Med & Epidemiol, Lubeck, Germany

[5] Univ Hosp Cologne, Inst Med Microbiol Immunol & Hyg, Fac Med, Cologne, Germany

[6] RKH Reg Kliniken Holding & Serv GmbH, Inst Clin Microbiol & Hosp Hyg, Hosp Ludwigsburg, Ludwigsburg, Germany

[7] Charite Univ Medizin Berlin, Inst Hyg & Environm Med, Berlin, Germany

[8] Humboldt Univ, Freie Univ Berlin, Berlin, Germany

[9] Berlin Inst Hlth, Berlin, Germany

[10] Univ Tubingen Hosp, Div Infect Dis, Dept Internal Med 1, Tubingen, Germany

[11] Justus Liebig Univ Giessen, Inst Med Microbiol, Giessen, Germany

[12] Justus Liebig Univ Giessen, Inst Hyg & Environm Med, Giessen, Germany

[13] Univ Med Ctr Freiburg, Inst Med Microbiol & Hyg, Freiburg, Germany

[14] Univ Tubingen, Inst Med Microbiol & Hyg, Tubingen, Germany

[15] Univ Hosp Cologne, Inst Translat Res, Cologne Excellence Cluster Cellular Stress Respon, Fac Med, Cologne, Germany

[16] Justus Liebig Univ Giessen, Dept Internal Med Infectiol, Giessen, Germany

[17] Univ Hosp Cologne, Dept Internal Med 1, Cologne, Germany

[18] Goethe Univ Frankfurt, Univ Hosp Frankfurt, Dept Internal Med 2, Infect Dis, Frankfurt, Germany

来源：

INFECTION | 2024年

关键词：

Bloodstream infection; Escherichia coli; Klebsiella; Cephalosporin resistance; ESBL prevalence; Longitudinal survey; KLEBSIELLA-PNEUMONIAE BACTEREMIA; ESCHERICHIA-COLI; ANTIMICROBIAL RESISTANCE; ENTEROBACTERIACEAE; EPIDEMIOLOGY; MULTICENTER; MORTALITY; IMPACT; MALIGNANCIES; PREDICTORS;

D O I：

10.1007/s15010-024-02430-7

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Purpose To analyze the longitudinal epidemiology and antimicrobial resistance (AMR) patterns of Gram-negative bloodstream infections (BSI) in Germany. Methods Post-hoc analysis of prospectively documented BSI due to Escherichia coli, Klebsiella spp., Enterobacter spp., Pseudomonas aeruginosa and Acinetobacter baumannii from six university hospitals between 2016 and 2020. In a subanalysis 1228 episodes of BSI (E. coli N=914, Klebsiella spp. N=314) were analyzed for clinical endpoints and risk factors. Results E. coli was the most prevalent cause of BSI, with 5412 cases, followed by Klebsiella spp. (2148 cases), P. aeruginosa (789 cases), Enterobacter spp. (696 cases), and A. baumannii (31 cases). BSI incidence rates were particularly high in haematology/oncology, with E. coli BSI reaching 13.9 per 1000 admissions. Most (58%) of the BSI episodes were community-acquired. A notable finding was the moderate increase of third-generation cephalosporin resistant Enterobacterales (3GCREB) for E. coli from 13.9% in 2016 to 14.4% in 2020 and a decrease for Klebsiella spp. from 16.5% in 2016 to 11.1% in 2020 corresponding to extended-spectrum betalactamase (ESBL) phenotype. In our analysis, the 3GCREB phenotype was not associated with a higher risk of death or discharge with sequelae for E. coli and Klebsiella spp. Conclusion Our study provides longitudinal data on Gram-negative BSI in Germany on a clinical basis for the first time. These data underscores the critical need for ongoing surveillance and more pathogen-related clinical data.

引用

页码：625 / 633

页数：9