TY - JOUR
T1 - Gram-negative bloodstream infections in six German university hospitals, 2016-2020
T2 - clinical and microbiological features
AU - Mischnik, Alexander
AU - DZIF R-NET Study Group
AU - Baltus, Hannah
AU - Walker, Sarah V
AU - Behnke, Michael
AU - Gladstone, Beryl Primrose
AU - Chakraborty, Trinad
AU - Falgenhauer, Linda
AU - Gastmeier, Petra
AU - Gölz, Hanna
AU - Göpel, Siri
AU - Häcker, Georg A
AU - Higgins, Paul G
AU - Imirzalioglu, Can
AU - Käding, Nadja
AU - Kramme, Evelyn
AU - Peter, Silke
AU - Rieg, Siegbert
AU - Rohde, Anna M
AU - Seifert, Harald
AU - Tacconelli, Evelina
AU - Tobys, David
AU - Trauth, Janina
AU - Vehreschild, Maria J G T
AU - Xanthopoulou, Kyriaki
AU - Rupp, Jan
AU - Kern, Winfried V
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - PURPOSE: To analyze the longitudinal epidemiology and antimicrobial resistance (AMR) patterns of Gram-negative bloodstream infections (BSI) in Germany.METHODS: Post-hoc analysis of prospectively documented BSI due to Escherichia coli, Klebsiella spp., Enterobacter spp., Pseudomonas aeruginosa and Acinetobacter baumannii from six university hospitals between 2016 and 2020. In a subanalysis 1228 episodes of BSI (E. coli N = 914, Klebsiella spp. N = 314) were analyzed for clinical endpoints and risk factors.RESULTS: E. coli was the most prevalent cause of BSI, with 5412 cases, followed by Klebsiella spp. (2148 cases), P. aeruginosa (789 cases), Enterobacter spp. (696 cases), and A. baumannii (31 cases). BSI incidence rates were particularly high in haematology/oncology, with E. coli BSI reaching 13.9 per 1000 admissions. Most (58%) of the BSI episodes were community-acquired. A notable finding was the moderate increase of third-generation cephalosporin resistant Enterobacterales (3GCREB) for E. coli from 13.9% in 2016 to 14.4% in 2020 and a decrease for Klebsiella spp. from 16.5% in 2016 to 11.1% in 2020 corresponding to extended-spectrum betalactamase (ESBL) phenotype. In our analysis, the 3GCREB phenotype was not associated with a higher risk of death or discharge with sequelae for E. coli and Klebsiella spp.CONCLUSION: Our study provides longitudinal data on Gram-negative BSI in Germany on a clinical basis for the first time. These data underscores the critical need for ongoing surveillance and more pathogen-related clinical data.
AB - PURPOSE: To analyze the longitudinal epidemiology and antimicrobial resistance (AMR) patterns of Gram-negative bloodstream infections (BSI) in Germany.METHODS: Post-hoc analysis of prospectively documented BSI due to Escherichia coli, Klebsiella spp., Enterobacter spp., Pseudomonas aeruginosa and Acinetobacter baumannii from six university hospitals between 2016 and 2020. In a subanalysis 1228 episodes of BSI (E. coli N = 914, Klebsiella spp. N = 314) were analyzed for clinical endpoints and risk factors.RESULTS: E. coli was the most prevalent cause of BSI, with 5412 cases, followed by Klebsiella spp. (2148 cases), P. aeruginosa (789 cases), Enterobacter spp. (696 cases), and A. baumannii (31 cases). BSI incidence rates were particularly high in haematology/oncology, with E. coli BSI reaching 13.9 per 1000 admissions. Most (58%) of the BSI episodes were community-acquired. A notable finding was the moderate increase of third-generation cephalosporin resistant Enterobacterales (3GCREB) for E. coli from 13.9% in 2016 to 14.4% in 2020 and a decrease for Klebsiella spp. from 16.5% in 2016 to 11.1% in 2020 corresponding to extended-spectrum betalactamase (ESBL) phenotype. In our analysis, the 3GCREB phenotype was not associated with a higher risk of death or discharge with sequelae for E. coli and Klebsiella spp.CONCLUSION: Our study provides longitudinal data on Gram-negative BSI in Germany on a clinical basis for the first time. These data underscores the critical need for ongoing surveillance and more pathogen-related clinical data.
UR - http://www.scopus.com/inward/record.url?scp=85210178208&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/43c9fa04-91a8-34f6-bb99-aa53ae2619dd/
U2 - 10.1007/s15010-024-02430-7
DO - 10.1007/s15010-024-02430-7
M3 - Journal articles
C2 - 39586959
SN - 0300-8126
JO - Infection
JF - Infection
ER -