scholarly journals Epidemiology, resistant pathogens and main causes of early death of bloodstream infection in patients with hematological malignancies from 2012 to 2019 in a Chinese tertiary hospital

2020 ◽  
Author(s):  
Meng Li ◽  
Mingmei Du ◽  
Honghua Li ◽  
Yunxi Liu ◽  
Daihong Liu

Abstract Background: To investigate epidemiology, antibiotic-susceptibility of pathogens, and risk factors for mortality of bloodstream infection (BSI) in patients with hematological malignancies (HMs).Methods: Single-centre retrospective analysis of BSI episodes in patients with HMs in a Chinese tertiary hospital from 2012 to 2019.Results: Among 17,796 analyzed admissions, 508 BSI episodes (2.85%) were identified. Of the 522 isolates, 326 (62.45%) were Gram-negative bacteria, 173 (33.14%) were Gram-positive bacteria, and 23 (4.41%) were fungi. The incidence of BSI differed significantly among the patients with different HMs (P = 0.000): severe aplastic anemia (6.67%), acute leukemia (6.15%), myelodysplastic syndrome(3.22%), multiple myeloma (1.29%), and lymphoma (1.02%). Escherichia coli (30.65%, 160/522) was the most common pathogens, followed by Coagulase-negative staphylococci (CoNS) (19.35%, 101/522) and Klebsiella pneumonia(9.96%, 52/522). The resistance rates of E. coli, K. pneumonia, P. aeruginosa, and A. baumannii to carbapenems were 6.42%, 15.00%, 27.78%, and 78.95%, respectively. All the Gram-positive pathogens were susceptible to linezolid, and 3 vancomycin-resistant Enterococcus were isolated. The overall 14-day mortality was 9.84%. The mortality of BSI caused by A. baumannii was 73.86%, while caused by other pathogens was 7.36% (p=0.000). A multivariate analysis showed that age >65 years, A. baumannii and non-remission of the malignancy were independent predictors of 14-day mortality.Conclusion: Gram-negative bacteria continued to be the most common pathogens causing BSIs in HM patients. An extensive multi-drug resistant baumanni with high mortality rate in HM patients made empirical antimicrobial choice a highly challenging issue.

2021 ◽  
Author(s):  
Samina Nazir Chaki ◽  
Levina Msuya ◽  
Deborah Mchaile ◽  
Michael Johnson Mahande ◽  
Ronald Mwitalemi Mbwasi ◽  
...  

Abstract Background: Bloodstream infections are major causes of morbidity and mortality among children in Sub-Saharan countries. This study aimed to determine the prevalence of bacteremia, etiological agents’ antibiotic susceptibility pattern and predictors of bacteremia among children with bloodstream Infection.Methodology: This hospital-based cross-section study involved children aged two months to thirteen years. All children meeting the inclusion criteria during the study period were enrolled. All consenting parents were interviewed via a questionnaire to collect data, followed by a thorough physical assessment and venipuncture was done to collect blood samples. Data were analysed using SPSS version 23.Results: Among 242 study participants, 154(63.6%) were male and blood cultures were positive in 37(15.3%). Gram-positive and gram-negative bacteria constituted 32(80%) and 8(20%), respectively. The frequent pathogen found was Staphylococcus aureus 25(62.5%), followed by Enterococcus spp. 4(10%), Escherichia coli 4(10%), Pseudomonas aeruginosa 3(7.5%), Streptococcus pyogenes 3(7.5%) and 1(2.5%) Klebsiella pneumonia. The majority of bacterial isolates showed high resistance to commonly used antibiotics in the study area. Predictors of bacteremia were severe malnutrition, hydrocephalus, hyperglycemia, lethargy and BSI with no foci of infection. Conclusion: Prevalence of bacteremia was 15.3%. Gram-positive bacteria were more prevalent than gram-negative bacteria. Staphylococcus aureus and Escherichia coli were the prevalent isolates causing BSI. Effective antibiotics for both gram-negative & gram-positive organisms are imipenem, meropenem and piperacillin-tazobactam followed by amikacin; vancomycin & clindamycin for gram-positive organisms. To curb the growing antimicrobial resistance that we see in this and other studies, continuous antimicrobial stewardship is necessary, else we risk failing to treat BSI.


2015 ◽  
Vol 7 (2) ◽  
pp. 71-75 ◽  
Author(s):  
Prashubha Bhandari ◽  
Sarita Manandhar ◽  
Basudha Shrestha ◽  
Nabeen Dulal

Background: Bloodstream infection (BSI) is a signifi cant cause of morbidity and mortality. In Nepal, very few studies on BSIs have restricted the understanding of their cause, prevention and treatment. This cross-sectional study was conducted to isolate BSIs causing pathogens and determine their antibiotic susceptibility pattern in patients visiting Kathmandu ModelHospital during December 2012 to May 2013.Materials and Methods: Standard laboratory procedure was used to screen, isolate and identify the bacteria from 1,205 patients. The antibiotic susceptibility pattern (AST) was analyzed by modifi ed Kirby Bauer technique and data were analyzed using SPSS version-16.Results: Out of 1,205 blood samples, 186 (15.4 %) were culture positive. The most common bacteria isolated were: Salmonella spp., Escherichiacoli, Klebsiella pneumoniae and CoNS. Gram-negative bacteria were the predominant causes of BSIs. Salmonella Typhi was isolated in 71 % cases of bloodstream infection followed by Salmonella Paratyphi A in 16 %, Escherichia coli in 5.3 % and Klebsiella pneumonia in 0.5 %. The gram-positive organism responsible for causing BSI was coagulase-negative staphylococcus in 7 % cases. There was no significant association between bacteremia and gender of the patients. During ASTs, Gram-negative bacteria were sensitive to Chloramphenicol with only 0.5 % resistivity. Salmonella Typhi (85.6 % of isolates) showed resistance to Nalidixic acid. Gram-positive bacteria showed 100 % sensitivity towards Chloramphenicol and Gentamicin and were least sensitive to Amoxicillin.Conclusion: Salmonella spp., was major cause of BSIs. Increase in antibiotic resistivity for BSI causing pathogens has necessitated continuous monitoring of the susceptibility of organisms towards antibiotics.Asian Journal of Medical Sciences Vol.7(2) 2015 71-75


2008 ◽  
Vol 29 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Pranavi V. Sreeramoju ◽  
Jocelyn Tolentino ◽  
Sylvia Garcia-Houchins ◽  
Stephen G. Weber

Objectives.To examine the relative proportions of central line-associated bloodstream infection (BSI) due to gram-negative bacteria and due to gram-positive bacteria among patients who had undergone surgery and patients who had not. The study also evaluated clinical predictive factors and unadjusted outcomes associated with central line-associated BSI caused by gram-negative bacteria in the postoperative period.Design.Observational, case-control study based on a retrospective review of medical records.Setting.University of Chicago Medical Center, a 500-bed tertiary care center located on Chicago's south side.Patients.Adult intensive care unit (ICU) patients who developed central line-associated BSI.Results.There were a total of 142 adult patients who met the Centers for Disease Control and Prevention National Nosocomial Infection Surveillance System definition for central line-associated BSI. Of those, 66 patients (46.5%) had infections due to gram-positive bacteria, 49 patients (34.5%) had infections due to gram-negative bacteria, 23 patients (16.2%) had infections due to yeast, and 4 patients (2.8%) had mixed infections. Patients who underwent surgery were more likely to develop central line-associated BSI due to gram-negative bacteria within 28 days of the surgery, compared with patients who had not had surgery recently (57.6% vs 27.3%; P = .002). On multivariable logistic regression analysis, diabetes mellitus (adjusted odds ratio [OR], 4.6 [95% CI, 1.2-18.1]; P = .03) and the presence of hypotension at the time of the first blood culture positive for a pathogen (adjusted OR, 9.8 [95% CI, 2.5-39.1]; P = .001 ) were found to be independently predictive of central line-associated BSI caused by gram-negative bacteria. Unadjusted outcomes were not different in the group with BSI due to gram-negative pathogens, compared to the group with BSI due to gram-positive pathogens.Conclusions.Clinicians caring for critically ill patients after surgery should be especially concerned about the possibility of central line-associated BSI caused by gram-negative pathogens. The presence of diabetes and hypotension appear to be significant associated factors.


2004 ◽  
Vol 48 (8) ◽  
pp. 2831-2837 ◽  
Author(s):  
Mizuyo Kurazono ◽  
Takashi Ida ◽  
Keiko Yamada ◽  
Yoko Hirai ◽  
Takahisa Maruyama ◽  
...  

ABSTRACT ME1036, formerly CP5609, is a novel parenteral carbapenem with a 7-acylated imidazo[5,1-b]thiazole-2-yl group directly attached to the carbapenem moiety of the C-2 position. The present study evaluated the in vitro activities of ME1036 against clinical isolates of gram-positive and gram-negative bacteria. ME1036 displayed broad activity against aerobic gram-positive and gram-negative bacteria. Unlike other marketed β-lactam antibiotics, ME1036 maintained excellent activity against multiple-drug-resistant gram-positive bacteria, such as methicillin-resistant staphylococci and penicillin-resistant Streptococcus pneumoniae (PRSP). The MICs of this compound at which 90% of isolates were inhibited were 2 μg/ml for methicillin-resistant Staphylococcus aureus (MRSA), 2 μg/ml for methicillin-resistant coagulase-negative staphylococci, and 0.031 μg/ml for PRSP. In time-kill studies with six strains of MRSA, ME1036 at four times the MIC caused a time-dependent decrease in the numbers of viable MRSA cells. The activity of ME1036 against MRSA is related to its high affinity for penicillin-binding protein 2a, for which the 50% inhibitory concentration of ME1036 was approximately 300-fold lower than that of imipenem. In conclusion, ME1036 demonstrated a broad antibacterial spectrum and high levels of activity in vitro against staphylococci, including β-lactam-resistant strains.


Author(s):  
Sotianingsih Sotianingsih ◽  
Samsirun H. ◽  
Lipinwati Lipinwati

Pneumonia is defined as an inflammation of the lungs caused by microorganisms (bacteria, viruses, fungi, parasites). This research aimed to determine the pneumonia-causing bacteria along with the sensitivity and the antibiotic resistance test. This research was a descriptive study with samples of ICU pneumonia patients at Raden Mattaher Regional Hospital during the study period. All samples were consecutively selected. Samples for blood culture were incubated in the BactAlert device, whereas the sensitivity test was then performed using Vitex instruments. Sputum was previously enriched with BHI media and then cultured on culture media, and sensitivity test with the Vitex instruments was carried out. Of the 354 ICU patients during the study period, 30 patients (11.8%) had pneumonia, but only 19 patients could undergo sputum culture. Five of 19 patients were infected with Gram-positive bacteria, and 14 patients were infected with Gram-negative bacteria. The most commonly found bacteria were Klebsiella pneumonia (36.84%), followed by Acinetobacter baumanii (21.05%) and Pseudomonas aeruginosa (10.53%). Gram-negative bacteria obtained from sputum culture in this study were resistant to almost all antibiotic groups, especially penicillin, cephalosporin, quinolone, and tetracycline groups. Gram-positive bacteria obtained from sputum culture in this study were resistant to the penicillin antibiotic. The most commonly found bacteria were Klebsiella pneumonia (36.84%), followed by Acinetobacter baumanii (21.05%) and Pseudomonas aeruginosa (10.53%). The bacteria cultured from the sputum showed multidrug resistance mainly to the penicillin and cephalosporin antibiotic. This research data can be used to consider the treatment of pneumonia patients to decide more appropriate therapy.


Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3703-3703
Author(s):  
Xiaofeng Luo ◽  
Jinhua Ren ◽  
Zhizhe Chen ◽  
Ting Yang ◽  
Jianda Hu

Abstract High procalcitonin (PCT) levels are strongly associated with systemic bacterial infections. PCT is produced in response to bacterial endotoxin and inflammatory cytokines. Few studies are available in the literature on PCT ability to distinguish different strains of bloodstream infections in patients with hematologic diseases. The aim of the present study was to explore the value of determining serum PCT values early, i.e., as soon as blood cultures are positive, in a large population of patients with hematologic diseases. Patients with hematologic diseases admitted to the hematology department of our hospitalfrom January 2013 to March 2016 who had bloodstream infections were retrospectively analyzed. Patients whose blood samples were collected for simultaneous blood culture and PCT test were enrolled in the study, and they were divided into agranulocytosis and non-agranulocytosis groups. Automatic microbial analyzer was used to identify all strains, and PCT levels were analyzed with an automatic electrochemiluminescence system. The relationship between PCT levels and the strains in bloodstream infections was analyzed and compared, and the diagnostic efficacy of PCT was evaluated using the receiver operating characteristic (ROC) curve. A total of 494 bloodstream infection cases that fulfilled the inclusion criteria were included in the study, involving 312 cases of bloodstream infection with single Gram-negative, 146 cases with single Gram-positive, 12 cases with single fungi, 19 cases with polymicrobes, and 5 cases identified as contaminated specimens. Unpaired t-test was used for data analysis. PCT levels for single Gram-negative infection (15.17±2.11 ng/ml) were significantly higher than those for Gram-positive infection (3.30 ± 0.93 ng/ml) (P<0.0001), or those for single fungi infection (0.22 ± 0.04 ng/ml) (P<0.0001). PCT levels for single Gram-positive infection were also significantly higher than those in single fungi infection (P<0.01). In the agranulocytosis group, which included 403 cases, the PCT levels in the single Gram-negative infection (14.14 ± 2.13 ng/ml) were significantly higher than those in single Gram-positive (2.49 ± 0.73 ng/ml) (P<0.0001), or in single fungi infection (0.24 ± 0.04 ng/ml) (P<0.0001). The PCT levels in the single Gram-positive bacterial infection were also significantly higher than those in single fungi infection (P<0.01). In the single Gram-negative bacteria bloodstream infection, we further found that the PCT levels in Enterobacteriaceae infection (17.00 ± 3.04 ng/ml) were significantly higher than those in nonfermentative Gram-negatives infection (6.49 ± 1.50 ng/ml) (P<0.01). ROC analysis was performed on monomicrobial blood cultures. ROC of single Gram-negative and Gram-positive infections revealed that the area under the curve (AUC) was 0.687, the best cut-off value was 0.58 ng/ml, the sensitivity was 60.81% and specificity was 71%. ROC of single Gram-negative and fungi infections revealed that the AUC was 0.795, the best cut-off value was 0.42 ng/ml, the sensitivity was 67% and specificity was 100%. ROC of single Gram-positive and fungi infections revealed that the AUC was 0.6, the best cut-off value was 0.44 ng/ml, the sensitivity was 37% and specificity was 100%. In the non-agranulocytosis group, we only found that the PCT levels in the single Gram-negative infection were significantly higher than those in single Gram-positive infection (P<0.05). In summary, early serum PCT quantitative determination can be used as a routine test to help to distinguish Gram-negative bacteria, Gram-positive bacteria, or fungi bloodstream infections in patients with hematologic diseases. These findings will be of great clinical value to select appropriate antibiotics for patients with hematologic diseases and bloodstream infections. Figure Figure. Disclosures No relevant conflicts of interest to declare.


2020 ◽  
Author(s):  
Jie Li ◽  
Junwei Wang ◽  
Yi Yang ◽  
Peishan Cai ◽  
Jingchao Cao ◽  
...  

Abstract Background: A considerable proportion of patients hospitalized with coronavirus disease 2019 (COVID-19) acquired secondary bacterial infections (SBIs). The etiology and antimicrobial resistance of bacteria were reported and used to provide a theoretical basis for appropriate infection therapy.Methods: This retrospective study reviewed electronic medical records of all the patients hospitalized with COVID-19 in the Wuhan Union Hospital between January 27 and March 17, 2020. According to the inclusion and exclusion criteria, patients who acquired SBIs were enrolled. Demographic, clinical course, etiology, and antimicrobial resistance data of the SBIs were collected. Outcomes were also compared between patients who were classified as severe and critical on admission.Results: Among 1495 patients hospitalized with COVID-19, 102 (6.8%) patients had acquired SBIs, and almost half of them (49.0%, 50/102) died during hospitalization. Compared with severe patients, critical patients had a higher chance of SBIs. Among the 159 strains of bacteria isolated from the SBIs, 136 strains (85.5%) were Gram-negative bacteria. The top three bacteria of SBIs were A. baumannii (35.8%, 57/159), K. pneumoniae (30.8%, 49/159), and S. maltophilia (6.3%, 10/159). The isolation rates of carbapenem-resistant A. baumannii and K. pneumoniae were 91.2% and 75.5%, respectively. Meticillin resistance was present in 100% of Staphylococcus aureus and Coagulase negative staphylococci, and vancomycin resistance was not found.Conclusions: SBIs may occur in patients hospitalized with COVID-19 and lead to high mortality. The incidence of SBIs was associated with the severity of illness on admission. Gram-negative bacteria, especially A. baumannii and K. pneumoniae, were the main bacteria, and the resistance rates of the major isolated bacteria were generally high. This was a single-center study; thus, our results should be externally examined when applied in other institutions.


Author(s):  
Emad M. Abdallah

Objective: The aim of this study was to evaluate the antibacterial potential of the male flowers of Phoenix dactylifera (date palm tree) against five Gram-positive and five Gram-negative bacteria. Methods: Male flowers were collected and extracted by maceration using 80% methanol and the antibacterial activity was determined using cup-plate diffusion test, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) tests. Results: The methanol extract of male flowers of Phoenix dactylifera showed varying degrees of antibacterial activity against tested bacterial strains, the most susceptible Gram-positive bacteria were Bacillus cereus and Streptococcus pneumonia which recorded 12.2±0.3 and 9.0±0.0 mm zone of inhibition (ZI), MIC values were 50 and 100 mg/ml, MBC values were 200 and ˂200 mg/ml, respectively. The most susceptible Gram-negative bacteria were Proteus vulgaris, Klebsiella pneumonia and Pseudomonas aeruginosa which recorded 10.0±0.0, 9.7±0.3 and 9.0±0.0 mm ZI, MIC values were 100 mg/ml and MBC values were 200 mg/ml, respectively.  Based on MBC/MIC ratio, the extract has some degree of bactericidal effect. However, the results were not competitive with the standard drug (Chloramphenicol). Conclusion: As a result, the tested methanol extract of male flowers of date palm tree exhibited some degree of antibacterial activity with a bactericidal property. More future studies such as fractionation process are required to isolate and investigate its bioactive compounds.


2020 ◽  
pp. 1-3
Author(s):  
Heri Gunanti Surbakti

Introduction: The principles management of complicated intra-abdominal infections are source control and antibiotic therapy. The main problem in its implementation is the slow handling time and inadequate antibiotic therapy, which leads in an increase in mortality in complicated intra-abdominal infections. Early empirical antibiotics are based on the pathological location and community microbial pattern. This study is aimed to evaluate microbial pattern at H. Adam Malik General Hospital between January 2017 and October 2019. Methods: This is a retro-prospective observational descriptive study. Results: There were 37 patients who met the inclusion criteria. The most common microbial pattern in this study was gramnegative bacteria, which was 62.1%. The most common gram-negative bacteria found were E.coli (32.4%), followed by Klebsiella pneumonia (24.3%). While the most common gram-positive bacteria found was Staphylococcus haemolyticus (8.1%). Conclusion: The most common microbial pattern found in this study was gram-negative bacteria, where the most common gram-negative bacteria was E. coli. The most common gram-positive bacteria was Staphylococcus haemolyticus


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ephrem Tsegay ◽  
Aregawi Hailesilassie ◽  
Haftamu Hailekiros ◽  
Selam Niguse ◽  
Muthupandian Saravanan ◽  
...  

This study was conducted in Ayder comprehensive specialized Hospital, Mekelle, Northern Ethiopia, to determine the bacterial profiles and drug susceptibility pattern from body fluids. A total of 218 patients were investigated, of which 146 (67%) were males. The age of the study subjects ranged from 2 days to 80 years with 96(44%) in the age group of 15 years and above. The overall bacterial infection was 44 (20.2 %) of which gram positive bacteria were prevalent, 23 (52.3%) than gram negative bacteria 21 (47.7%). The predominantly isolated bacteria wereS. pneumonia,followed byK.pneumoniae, S. aureus, andE coli.Multidrug resistance was observed in 12 (100%) of the isolated gram positive bacteria and in 6 (75%) of the isolated gram negative bacteria.


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