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Epidemiology of bacteremia episodes in a single center: increase in Gram-negative isolates, antibiotics resistance, and patient age

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Abstract

Increased resistance among isolates causing bacteremia constitutes a major challenge to medical practitioners and institutions. Variability between institutes is substantial, and requires the individual analysis of local trends. An eight-year (1997–2004) surveillance study of episodes of bacteremia was conducted in an 850-bed university hospital in central Israel. Trends of incidence, resistance, age, and mortality were analyzed. We studied 6,096 patient-unique episodes of bacteremia, of which, 2,722 (45.3%) were nosocomial and 523 (9.2%) involved children less than 18 years of age. The overall incidence of bacteremia episodes has increased over the study years by 39% and the patient mean age by 7.5 years. Gram-negative organisms accounted for 72% of hospital-acquired cases and 69% of community-acquired cases. There was a substantial increase in the incidence of nosocomial episodes, predominantly due to Gram-negative isolates, mainly Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli. Increased resistance to broad-spectrum antibiotics was noted among Gram-negative organisms, including quinolones (in K. pneumoniae), imipenem (A. baumannii and P. aeruginosa), piperacillin-tazobactam (K. pneumoniae), and amikacin (A. baumannii and P. aeruginosa). Increased resistance to oxacillin among coagulase-negative staphylococci was also noted. The all-cause mortality rates showed a significant rise. The patient age, intensive care unit (ICU) stay, and hospital acquisition were independently associated with mortality. We describe an increase in the incidence and resistance of Gram-negative organisms causing bacteremia and concomitant ageing of the patients with bacteremia. Similar patterns have been reported from other localities, and are of real concern.

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Author notes

  1. D. Marchaim

    Present address: Infection Control Unit, Tel Aviv Medical Center, Tel Aviv, Israel

Authors and Affiliations

  1. Infectious Diseases Unit, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    D. Marchaim, R. Zaidenstein, Y. Karpuch & M. Weinberger

  2. Microbiology Laboratory, Assaf Harofeh Medical Center, Zerifin, Israel

    T. Lazarovitch

  3. Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel

    T. Ziv & M. Weinberger

Authors
  1. D. Marchaim
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  2. R. Zaidenstein
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  3. T. Lazarovitch
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  4. Y. Karpuch
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  5. T. Ziv
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  6. M. Weinberger
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Correspondence to M. Weinberger.

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Marchaim, D., Zaidenstein, R., Lazarovitch, T. et al. Epidemiology of bacteremia episodes in a single center: increase in Gram-negative isolates, antibiotics resistance, and patient age. Eur J Clin Microbiol Infect Dis 27, 1045–1051 (2008). https://doi.org/10.1007/s10096-008-0545-z

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  • DOI: https://doi.org/10.1007/s10096-008-0545-z

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