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

作     者：Jian-nong WU Tie-er GAN Yue-xian ZHU Jun-min CAO Cong-hua JI Yi-hua WU Bin LV 

作者机构：Department of Hospital Infection Control the First Affiliated Hospital of Zhejiang Chinese Medical University Microbiology Laboratory the First Affiliated Hospital of Zhejiang Chinese Medical University Clinical Evaluation and Analysis Center the First Affiliated Hospital of Zhejiang Chinese Medical University Department of Epidemiology and Health Statistics School of Public Health Zhejiang University Department of Gastroenterology the First Affiliated Hospital of Zhejiang Chinese Medical University 

出 版 物：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 (浙江大学学报（英文版）B辑（生物医学与生物技术）)

年 卷 期：2015年第16卷第1期

页      面：70-77页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：supported by the Projects of Zhejiang Province Non-profit Technology Research(No.2013C33180) China 

主　　题：Nosocomial bloodstream infection Traditional Chinese medicine hospital Epidemiology Microbiology 

摘      要：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 sur- veillance 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 Klebsie/la 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 glyco- peptide were the most frequently used for nBSI therapy. Only about one-third of patients （157/482） received appro- priate 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.