Changing epidemiology and prognosis of nosocomial bloodstream infection: A single-center retrospective study in Taiwan

Nosocomial bloodstream infection (BSI) remains a significant cause of mortality and morbidity. We evaluate the trend of the pathogens of nosocomial BSI and investigate the distribution of the pathogens to demonstrate the risk factors of mortality. In this retrospective study, we collected data from...

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Published in:Journal of microbiology, immunology and infection immunology and infection, 2022-12, Vol.55 (6), p.1293-1300
Main Authors: Liao, Wei-Chih, Chung, Wei-Sheng, Lo, Ying-Chieh, Shih, Wen-Hsin, Chou, Chia-Hui, Chen, Chih-Yu, Tu, Chih-Yen, Ho, Mao-Wang
Format: Article
Language:English
Subjects:
Bacteremia - epidemiology
Bacteremia - microbiology
Bloodstream infection
Cross Infection - microbiology
Escherichia coli
Humans
Liver Cirrhosis - complications
Liver Cirrhosis - epidemiology
Nosocomial infection
Prognosis
Retrospective Studies
Risk Factors
Taiwan - epidemiology
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Summary:Nosocomial bloodstream infection (BSI) remains a significant cause of mortality and morbidity. We evaluate the trend of the pathogens of nosocomial BSI and investigate the distribution of the pathogens to demonstrate the risk factors of mortality. In this retrospective study, we collected data from a 2076-bed tertiary referral center that offers a full range of clinical services in central Taiwan during January, 2016 to December, 2017. Five hundred and eighty-four patients were identified with nosocomial BSI. Among the comorbidities of nosocomial BSI patients with, the most frequent were hypertension, in 294 patients (50.3%), malignancy, in 279 patients (47.8%); diabetes, in 278 patients (47.6%); chronic kidney disease, in 171 patients (29.3%); and liver cirrhosis, in 132 patients (22.6%). Gram-positive organisms caused 22.9% of these nosocomial BSIs, gram-negative organisms caused 69.2%, and fungi caused 6.8%. The most common organism causing nosocomial BSIs were Klebsiella spp. (14%), E coli. (14%), and Enterococcus spp. (11%). Multivariate analysis of risk factors for mortality displayed that comorbidity with low body weight, liver cirrhosis, and malignancy, high CRP level, high Charlson Comorbidity Index and internal medicine and hematology/oncology distribution were strikingly associated with mortality (P = 0.0222, 0.0352, 0.0008, 0.0122,
ISSN:1684-1182
1995-9133
DOI:10.1016/j.jmii.2021.09.015