Clinical characteristics and pathogen profile in 193 cases of community acquired bloodstream infection / 中国感染与化疗杂志

ABSTRACT

Objective To understand the clinical and pathogen characteristics of community acquired bloodstream infection(CABSI)for improving empirical antimicrobial therapy. Methods The clinical and laboratory findings of 193 CABSI cases in the Fifth Affiliated(Zhuhai)Hospital of Zunyi Medical College from 2013 to 2017 were retrospectively analyzed. Results Of the193 CABSI cases, 97.9％(189/193)had underlying diseases and/or risk factors. Primary site of infection was identified in 81.3％(157/193)of the patients. The top three primary site of infection was urinary tract(39.5％, 62/157), hepatobiliary system(22.9％, 36/157)and lower respiratory tract(20.4％, 32/157). The top pathogens included Escherichia coli(47.2％), Klebsiella pneumoniae(15.0％), coagulase-negative Staphylococcus(10.4％), and Streptococcus spp.(7.8％). All the E. coli and K. pneumoniae strains were susceptible to carbapenems. More than 90％ of the E. coli and K. pneumoniae strains were susceptible to piperacillin-tazobactam and amikacin. About 54.9％(50/91)of the E. coli and 27.6％(8/29)of the K. pneumoniae strains produced extended-spectrum β-lactamases(ESBLs). No vancomycin-resistant gram-positive bacteria were detected. The prevalence of MRCNS and MRSA was 35.0％ and 0, respectively. Conclusions Most CABSI cases had underlying diseases and/or risk factors. The common primary site of infection associated with secondary bloodstream infection is urinary tract, hepatobiliary system, and lower respirtaory tract. Enterobacteriaceae strains are the main pathogen of CABSI.