Epidemiology and microbiology of Gram-negative bloodstream infections in a tertiary-care hospital in Beijing, China: a 9-year retrospective study

ABSTRACT

Background: Gram-negative bacterial bloodstream infections (BSIs) are associated with high morbidity and mortality. The present study examines the incidence, clinical characteristics, microbiological features, drug resistance and mortality associated with Gram-negative bacterial BSIs at a tertiary-care hospital in Beijing, China.

Methods: This retrospective cohort study of patients with Gram-negative bacterial BSIs was performed between 1 January 2010 and 31 December 2018 at the Chinese People^,s Liberation Army General Hospital.

Results: A total of 6867 episodes of Gram-negative bacterial BSIs occurred among 3199 patients over 9 years. The overall incidence of Gram-negative bacterial BSIs fluctuated from 2.30 to 2.55 episodes per 1000 admissions over 9 years. Escherichia coli was the major pathogen (34.3%). The antibiotic resistance of ESBLs-producing E. coli was higher than non-ESBLs producing E. coli including the majority of antibiotics, but to carbapenems (0.7% VS 5.1%). Between 2010 and 2018, the overall mortality of Gram-negative bacterial BSIs decreased from 11.41% to 9.05% (X² = 6.95, P = 0.434).

Conclusions: Cephalosporins and carbapenem antibiotics were considered as the optimal treatment for patients with Gram-negative bacterial BSIs except for A. baumannii, which was treated according to the drug sensitivity or multidrug combination.

KEYWORDS:

• Gram-negative bacteria
• bloodstream infections
• epidemiology
• incidence
• resistance
• outcome

Acknowledgments

We thank all our colleagues at the Infection Management and Disease Control Department for making this study possible.

Availability of data and materials

The datasets generated during the current study are not publicly available to maintain the privacy of the patients, but they are available from the corresponding author on reasonable request.

Ethics approval and consent to participate

The local institutional review board approved this study. The formal consent is not required in our hospital.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This study was supported by the Military Medical Innovation Program of China [16CXZ041].