Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study

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• 作者：Jian-nong Wu (1)
  Tie-er Gan (1)
  Yue-xian Zhu (1)
  Jun-min Cao (2)
  Cong-hua Ji (3)
  Yi-hua Wu (4)
  Bin Lv (5)
  
  1. Department of Hospital Infection Control ; the First Affiliated Hospital of Zhejiang Chinese Medical University ; Hangzhou ; 310006 ; China
  2. Microbiology Laboratory ; the First Affiliated Hospital of Zhejiang Chinese Medical University ; Hangzhou ; 310001 ; China
  3. Clinical Evaluation and Analysis Center ; the First Affiliated Hospital of Zhejiang Chinese Medical University ; Hangzhou ; 310001 ; China
  4. Department of Epidemiology and Health Statistics ; School of Public Health ; Zhejiang University ; Hangzhou ; 310058 ; China
  5. Department of Gastroenterology ; the First Affiliated Hospital of Zhejiang Chinese Medical University ; Hangzhou ; 310001 ; China
  
• 关键词：Nosocomial bloodstream infection ; Traditional Chinese medicine hospital ; Epidemiology ; Microbiology ; R181.2+2 ; 鍖婚櫌鑾峰緱鎬ц娴佹劅鏌?/li> 涓尰闄?/li> 娴佽鐥呭 ; 鐥呭師瀛?/li>
• 刊名：Journal of Zhejiang University SCIENCE B
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：16
• 期：1
• 页码：70-77
• 全文大小：499 KB
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• 刊物主题：Biomedicine general;
• 出版者：Springer Berlin Heidelberg
• ISSN：1862-1783

文摘

In many traditional Chinese medicine (TCM) hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality. A retrospective surveillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions. Escherichia coli (25.5%) was the most common Gram-negative and coagulase-negative staphylococcus (CoNS) (14.1%) was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsiella pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glycopeptide were the most frequently used for nBSI therapy. Only about one-third of patients (157/482) received appropriate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score >4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.