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

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-04-01 Epub Date: 2024-11-25 DOI:10.1007/s15010-024-02430-7

Alexander Mischnik, Hannah Baltus, Sarah V Walker, Michael Behnke, Beryl Primrose Gladstone, Trinad Chakraborty, Linda Falgenhauer, Petra Gastmeier, Hanna Gölz, Siri Göpel, Georg A Häcker, Paul G Higgins, Can Imirzalioglu, Nadja Käding, Evelyn Kramme, Silke Peter, Siegbert Rieg, Anna M Rohde, Harald Seifert, Evelina Tacconelli, David Tobys, Janina Trauth, Maria J G T Vehreschild, Kyriaki Xanthopoulou, Jan Rupp, Winfried V Kern

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引用次数: 0

Abstract

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.

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2016-2020 年德国六所大学医院的革兰氏阴性血流感染：临床和微生物学特征。

目的：分析德国革兰氏阴性血流感染（BSI）的纵向流行病学和抗菌药耐药性（AMR）模式：对 2016 年至 2020 年期间六所大学医院前瞻性记录的由大肠埃希菌、克雷伯菌属、肠杆菌属、铜绿假单胞菌和鲍曼不动杆菌引起的 BSI 进行事后分析。在一项子分析中，对1228例BSI病例（大肠杆菌914例，克雷伯氏菌314例）的临床终点和风险因素进行了分析：结果：大肠杆菌是导致 BSI 的最主要原因，共 5412 例，其次是克雷伯菌属（2148 例）、铜绿假单胞菌属（789 例）、肠杆菌属（696 例）和鲍曼不动杆菌属（31 例）。血液科/肿瘤科的 BSI 感染率尤其高，大肠杆菌 BSI 感染率达到每 1000 例住院病人中 13.9 例。大多数（58%）的 BSI 病例是在社区获得的。一个值得注意的发现是，对第三代头孢菌素耐药的大肠杆菌（3GCREB）从2016年的13.9%适度增加到2020年的14.4%，而与广谱β内酰胺酶（ESBL）表型相对应的克雷伯菌属从2016年的16.5%减少到2020年的11.1%。在我们的分析中，3GCREB表型与大肠埃希菌和克雷伯菌属的较高死亡或出院后遗症风险无关：我们的研究首次提供了德国革兰氏阴性 BSI 临床纵向数据。这些数据强调了对持续监测和更多病原体相关临床数据的迫切需要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.