Revisiting the epidemiology of bloodstream infections and healthcare-associated episodes: results from a multicentre prospective cohort in Spain (PRO-BAC Study)
Por:
Perez-Crespo, P, Lanz-Garcia, J, Bravo-Ferrer, J, Canton-Bulnes, M, Dominguez, A, Aguirre, J, Reguera-Iglesias, J, Jimenez, E, Castillo, C, Vallejo, M, Ciordia, T, Suarez, J, Boix-Palop, L, Pedragosa, J, Saenz, A, Blanco, J, Galan-Sanchez, F, Kindelan, C, Jimenez, A, Bahamonde-Carrasco, A, Amat, A, Garcia, D, Rodriguez, C, Molina, I, Camacho, I, Sanchez-Porto, A, Garcia, M, Carral, B, de Lucas, E, Lopez-Hernandez, I, Rodriguez-Bano, J, Lopez-Cortes, L and PROBAC REIPI GEIH-SEIMC SAEI Grp
Publicada:
1 jul 2021
Ahead of Print:
1 jun 2021
Resumen:
The epidemiology of bloodstream infections (BSIs) is dynamic as it depends on microbiological, host and healthcare system factors. The aim of this study was to update the information regarding the epidemiology of BSIs in Spain considering the type of acquisition. An observational, prospective cohort study in 26 Spanish hospitals from October 2016 through March 2017 including all episodes of BSI in adults was performed. Bivariate analyses stratified by type of acquisition were performed. Multivariate analyses were performed by logistic regression. Overall, 6345 BSI episodes were included; 2510 (39.8%) were community-acquired (CA), 1661 (26.3%) were healthcare-associated (HCA) and 2056 (32.6%) hospital-acquired (HA). The 30-day mortality rates were 11.6%, 19.5% and 22.0%, respectively. The median age of patients was 71 years (interquartile range 60-81 years) and 3656 (58.3%; 95% confidence interval 57.1-59.6%) occurred in males. The proportions according to patient sex varied according to age strata. Escherichia coli (43.8%), Klebsiella spp. (8.9%), Staphylococcus aureus (8.9%) and coagulase-negative staphylococci (7.4%) were the most frequent pathogens. Multivariate analyses confirmed important differences between CA and HCA episodes, but also between HCA and HA episodes, in demographics, underlying conditions and aetiology. In conclusion, we have updated the epidemiological information regarding patients' profiles, underlying conditions, frequency of acquisition types and aetiological agents of BSI in Spain. HCA is confirmed as a distinct type of acquisition. (C) 2021 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.
Filiaciones:
Perez-Crespo, P:
Univ Seville, Hosp Univ Virgen Macarena, Unidad Clin Enfermedades Infecciosas Microbiol &, Dept Med,Inst Biomed Sevilla, Seville, Spain
Hosp Univ Nuestra Senora Valme, Unidad Enfermedades Infecciosas & Microbiol, Seville, Spain
Lanz-Garcia, J:
Univ Seville, Hosp Univ Virgen Macarena, Unidad Clin Enfermedades Infecciosas Microbiol &, Dept Med,Inst Biomed Sevilla, Seville, Spain
Bravo-Ferrer, J:
Univ Seville, Hosp Univ Virgen Macarena, Unidad Clin Enfermedades Infecciosas Microbiol &, Dept Med,Inst Biomed Sevilla, Seville, Spain
Canton-Bulnes, M:
Hosp Univ Virgen Macarena, Unidad Cuidados Intensivos, Seville, Spain
Dominguez, A:
Hosp Alvaro Cunqueiro, Serv Med Interna, Unidad Enfermedades Infecciosas, Vigo, Spain
Aguirre, J:
Hosp Univ Cruces, Unidad Enfermedades Infecciosas, Bizkaia, Spain
Reguera-Iglesias, J:
Hosp Reg Univ Malaga, Serv Enfermedades Infecciosas, IBIMA Malaga, Malaga, Spain
Jimenez, E:
Hosp Univ Nuestra Senora Valme, Unidad Enfermedades Infecciosas & Microbiol, Seville, Spain
Castillo, C:
Univ Cantabria, Hosp Univ Marques de Valdecilla, IDIVAL, Unidad Enfermedades Infecciosas, Santander, Spain
Vallejo, M:
Hosp Univ Burgos, Unidad Gest Clin Enfermedades Infecciosas, Burgos, Spain
Ciordia, T:
Complejo Asistencial Univ Leon CAULE, Dept Microbiol Clin, Leon, Spain
Suarez, J:
Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA, Unidad Microbiol, Oviedo, Spain
Boix-Palop, L:
Hosp Univ Mutua Terrassa, Serv Med Interna, Unidad Enfermedades Infecciosas, Barcelona, Spain
Pedragosa, J:
Hosp Univ Granollers, Dept Med Interna, Granollers, Spain
Saenz, A:
Hosp Arnau Vilanova, Unidad Func Infecc Nosocomiales, Lerida, Spain
Blanco, J:
Hosp Univ Jerez de la Frontera, Unidad Gest Clin Enfermedades Infecciosas & Micro, Jerez de la Frontera, Spain
Galan-Sanchez, F:
Hosp Univ Puerta Mar, Unidad Gest Clin Microbiol, Cadiz, Spain
Kindelan, C:
Hosp Univ Reina Sofia, Unidad Clin Enfermedades Infecciosas, Cordoba, Spain
Jimenez, A:
Hosp Costa Sol, Serv Med Interna, Grp Enfermedades Infecciosas, Marbella, Spain
Bahamonde-Carrasco, A:
Hosp El Bierzo, Dept Med Interna, Ponferrada, Spain
Amat, A:
Fundacio Hosp Esperit St, Unidad Med Interna, Santa Coloma De Gramenet, Spain
Garcia, D:
Hosp Univ Clin San Cecilio, Unidad Gest Clin Enfermedades Infecciosas, Granada, Spain
Rodriguez, C:
Complejo Hosp Jaen, Unidad Gest Clin Enfermedades Infecciosas & Micro, Jaen, Spain
Molina, I:
Hosp Univ Torrecardenas, Unidad Enfermedades Infecciosas, Almeria, Spain
Camacho, I:
Hosp Gen Poniente, Unidad Med Trop, El Ejido, Spain
Sanchez-Porto, A:
Hosp la Linea de la Concepcion, Unidad Enfermedades Infecciosas & Microbiol, La Linea De Concepcion, Spain
Garcia, M:
Hosp San Juan de la Cruz, Serv Med Interna, Ubeda, Spain
Carral, B:
Area Sanitaria Campo Gibraltar, Unidad Clin Gest Enfermedades Infecciosas & Micro, Cadiz, Spain
:
Hosp Univ Gen Alicante, Unidad Enfermedades Infecciosas, Alicante, Spain
Lopez-Hernandez, I:
Univ Seville, Hosp Univ Virgen Macarena, Unidad Clin Enfermedades Infecciosas Microbiol &, Dept Med,Inst Biomed Sevilla, Seville, Spain
Rodriguez-Bano, J:
Univ Seville, Hosp Univ Virgen Macarena, Unidad Clin Enfermedades Infecciosas Microbiol &, Dept Med,Inst Biomed Sevilla, Seville, Spain
Lopez-Cortes, L:
Univ Seville, Hosp Univ Virgen Macarena, Unidad Clin Enfermedades Infecciosas Microbiol &, Dept Med,Inst Biomed Sevilla, Seville, Spain
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