Characteristics of Secondary Bloodstream Infections at the Region of İstanbul Northern Anatolian Association of Public Hospitals
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Original Research
P: 38-43
March 2022

Characteristics of Secondary Bloodstream Infections at the Region of İstanbul Northern Anatolian Association of Public Hospitals

J Turk Soc Intens Care 2022;20(1):38-43
1. Sağlık Bilimleri Üniversitesi, Ümraniye Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Kliniği, İstanbul, Türkiye
2. Sağlık Bilimleri Üniversitesi Ümraniye Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Kliniği, İstanbul, Türkiye
3. Sağlık Bilimleri Üniversitesi Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Kliniği, İstanbul, Türkiye
4. Sağlık Bilimleri Üniversitesi, Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Kliniği, İstanbul, Türkiye
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No information available
Received Date: 24.01.2020
Accepted Date: 20.02.2020
Publish Date: 02.03.2022
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ABSTRACT

Objective:

The aim of this study was detect to infection source before the bloodstream infection (BSI) of patients with secondary BSI to examine the epidemiological features, sources of infection, prognosis and antibiotic resistance.

Materials and Methods:

Culture/antibiotic susceptibility results of all hospitalized patients were evaluated retrospectively. Age, gender, localization of infection, causative microorganism, antibiogram test results, time frame between primary and secondary BSI and prognosis of each patients with secondary BSI was investigated.

Results:

In a total of 1,584 patients, secondary BSI was detected in 200 patients, 158 (79%) of them in the intensive care unit and 42 (21%) of inpatient services. Median of time between primary and secondary bloodstream infections among specimen species were statistically insignificant (p=0.091). Urinary tract infection (37%) is the most common, followed by respiratory tract infections (31%), skin and soft tissue infections (18%), central nervous system infections (10%) and other infections (4%). Acinetobacter baumannii complex species had a resistance against more than 95% of antibiotics except aminoglycosides. Resistance to carbapenem group antibiotics was observed at a rate of 2% in Escherichia coli strains and the rate was found to be 35% in Klebsiella pneumoniae isolates. Methicillin resistance was found in 29% of Staphylococcus aureus and 90% of coagulase negative staphylococci and 25% of Enterococcus spp. were resistant to vancomycin.

Conclusion:

Knowing a source of infection in secondary bloodstream infections will lead to an identification of risk factors for infections and a description of infection control practices. It will reduce health expenditure as well as mortality rate.

Keywords: Secondary blood stream infections, nosocomial infections, antibiotic resistance

References

1
Karchmer AW. Nosocomial bloodstream infections: organisms, risk factors, and implications. Clin Infect Dis 2000;31 Suppl 4:S139-43. 
2
Pittet D, Li N, Wenzel RP. Association of secondary and polymicrobial nosocomial bloodstream infections with higher mortality. Eur J Clin Microbiol Infect Dis 1993;12:813-9. 
3
Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309-32. 
4
Kadanalı A, Kızılkaya M, Altoparlak Ü, Kürşat H, Parlak M. Investigation of source of infection in bacteremic patients in an intensive care unit. ANKEM Derg 2004;18:32-5.
5
Suetens C, Hopkins S, KolmanJ, Högberg LD. ECDC surveillance report: point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals, 2011–2012. Stockholm: European Centre for Disease Prevention and Control, 2013.
6
Akalın E. Hastane infeksiyonlarında ‘Sıfır İnfeksiyon’ hedefi: Ne kadar gerçekçi? Hastane İnfeksiyonları Dergisi 2011;15:26-8.
7
Andersen BM. Hospital Infections: Surveillance. In: Prevention and Control of Infections in Hospitals. Springer Cham; 2019. p. 13-22.
8
Baviskar AS, Khatib KI, Rajpal D, Dongare HC. Nosocomial infections in surgical intensive care unit: A retrospective single-center study. Int J Crit Illn Inj Sci 2019;9:16-20. 
9
Wang L, Zhou KH, Chen W, Yu Y, Feng SF. Epidemiology and risk factors for nosocomial infection in the respiratory intensive care unit of a teaching hospital in China: A prospective surveillance during 2013 and 2015. BMC Infect Dis 2019;19:145. 
10
Sante L, Aguirre-Jaime A, Miguel MA, Ramos MJ, Pedroso Y, Lecuona M. Epidemiological study of secondary bloodstream infections: The forgotten issue. J Infect Public Health 2019;12:37-42. 
11
Barış A, Bulut ME, Öncül A, Bayraktar B. Yoğun Bakım Ünitelerinde Yatan Hastalara Ait Klinik İzolatların Tür Dağılımı ve Antibiyotik Duyarlılıkları. J Turk Intense Care 2017;15:21-7.
12
Uğur M, Genç S. Three year resistance profile of Acinetobacter baumonnii and Pseudomonas aeruginosa strains isolated from intensive care units. J Turk Soc Intens Care 2019;17:130-7.
13
Lob SH, Hoban DJ, Sahm DF, Badal RE. Regional differences and trends in antimicrobial susceptibility of Acinetobacter baumannii. Int J Antimicrob Agents 2016;47:317-23.
14
Sader HS, Farrell DJ, Flamm RK, Jones RN. Antimicrobial susceptibility of Gram-negative organisms isolated from patients hospitalized in intensive care units in United States and European hospitals (2009-2011). Diagn Microbiol Infect Dis 2014;78:443-8.
15
Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest 2000;118:146-55. 
16
Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest 1999;115:462-74. 
17
Nordmann P, Poirel L. Epidemiology and Diagnostics of Carbapenem Resistance in Gram-negative Bacteria. Clin Infect Dis 2019;69(Suppl 7):S521-8. 
18
World Health Organization. Central Asian and European Surveillance of Antimicrobial Resistance Annual report 2019. Available from URL: https://www.euro.who.int/__data/assets/pdf_file/0003/418863/53373-WHO-CAESAR-annual-report-2019.pdf.
19
European Committee on Antimicrobial Susceptibility Testing (EUCAST). Available from: http:// www.eucast.org/ast_of_bacteria/ warnings/#c13111. Accessed November 14 2018.
20
Ulusal Sağlık Hizmeti İlişkili Enfeksiyonlar Sürveyans Ağı Özet Raporu 2017. Available from: https://hsgm.saglik.gov.tr/depo/Duyurular/Surveyans_Agi_Ozet_Raporu_2017/USHIESA_OZET_RAPOR_2017.pdf.
21
Köksal İ. Yoğun bakımda gram pozitif bakteri sorunu. ANKEM Derg 2009;23(Özel Sayı 2):143-7.
22
Lam PW, Wiggers JB, Lo J, MacFadden DR, Daneman N. Utility of Urine Cultures in Predicting Blood Culture Susceptibilities in Patients with Bacteremic Urinary Tract Infection. Antimicrob Agents Chemother 2018;63:e01606-18. 
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