TY - JOUR
T1 - Distribution of pathogens and antimicrobial resistance in bacteraemia according to hospitalization duration
T2 - a nationwide surveillance study in Switzerland
AU - the Swiss Centre for Antibiotic resistance (ANRESIS)
AU - Buetti, Niccolò
AU - Marschall, Jonas
AU - Timsit, Jean François
AU - Atkinson, Andrew
AU - Kronenberg, Andreas
AU - Sommerstein, Rami
AU - Burnens, A.
AU - Cherkaoui, A.
AU - Corradi, C.
AU - Dubuis, O.
AU - Viollier, A. G.
AU - Egli, A.
AU - Gaia, V.
AU - Koch, D.
AU - Kronenberg, A.
AU - Leib, S. L.
AU - Marschall, J.
AU - Nordmann, P.
AU - Perreten, V.
AU - Piffaretti, J. C.
AU - Prod'hom, G.
AU - Schrenzel, J.
AU - Widmer, A. F.
AU - Zanetti, G.
AU - Zbinden, R.
N1 - Funding Information:
The authors declare that they have no conflicts of interest. J.F.T. received fees for lectures to 3M, MSD, Pfizer, and Biomerieux. J.F.T. received research grants from Astellas, 3M, MSD and Pfizer. J.F.T. participated to advisory boards of 3M, MSD, Bayer Pharma, Nabriva and Pfizer. ANRESIS is co-financed by the Institute for Infectious Diseases, University of Bern and the Swiss Federal Office of Public Health (SFOPH). A.K. has received travel grant and meeting expenses from Gilead, Viofor and the World Health Organization (WHO). A.K. provides not interpreted annual resistance data to LEO pharmaceutic company and the Swiss government. A.K. is advisor of the SFOPH concerning antibiotic resistance epidemiology in Switzerland. This work was supported by the Swiss National Science Foundation. NB is currently receiving a post doc Mobility grant from the Swiss National Science Foundation (grant number: P4P4PM_194449).
Funding Information:
The authors declare that they have no conflicts of interest. J.F.T. received fees for lectures to 3M, MSD , Pfizer , and Biomerieux . J.F.T. received research grants from Astellas , 3M, MSD and Pfizer . J.F.T. participated to advisory boards of 3M, MSD, Bayer Pharma, Nabriva and Pfizer. ANRESIS is co-financed by the Institute for Infectious Diseases, University of Bern and the Swiss Federal Office of Public Health (SFOPH) . A.K. has received travel grant and meeting expenses from Gilead, Viofor and the World Health Organization (WHO). A.K. provides not interpreted annual resistance data to LEO pharmaceutic company and the Swiss government. A.K. is advisor of the SFOPH concerning antibiotic resistance epidemiology in Switzerland. This work was supported by the Swiss National Science Foundation . NB is currently receiving a post doc Mobility grant from the Swiss National Science Foundation (grant number: P4P4PM_194449 ).
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/12
Y1 - 2021/12
N2 - Objectives: Changing microorganism distributions and decreasing antibiotic susceptibility with increasing length of hospital stay have been demonstrated for the colonization or infection of selected organ systems. We wanted to describe microorganism distribution or antibiotic resistance in bacteraemia according to duration of the hospitalization using a large national epidemiological/microbiological database (ANRESIS) in Switzerland. Methods: We conducted a nationwide, observational study on bacteraemia using ANRESIS data from 1 January 2008 to 31 December 2017. We analysed data on bacteraemia from those Swiss hospitals that sent information on a regular basis during the entire study period. We described the pathogen distribution and specific trends of resistance during hospitalization for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Serratia marcescens and Staphylococcus aureus. Results: We included 28 318 bacteraemia isolates from 90 Swiss hospitals. The most common aetiology was E. coli (33.4%, 9459), followed by S. aureus (16.7%, 4721), K. pneumoniae (7.1%, 2005), Enterococcus faecalis (5.2%, 1473), P. aeruginosa (4.3%, 1228), Streptococcus pneumoniae (4.3%, 1208) and Enterococcus faecium (3.9%, 1101). We observed 489 (1.73%) S. marcescens isolates. We observed an increasing trend for E. faecium (from 1.5% at day 0 to 13.7% at day 30; p < 0.001), K. pneumoniae (from 6.1% to 7.8%, p < 0.001) and P. aeruginosa (from 2.9% to 13.7%, p < 0.001) with increasing duration of hospitalization; and decreasing trends for E. coli (from 41.6% to 21.6%; p < 0.001) and S. aureus (p < 0.001). Ceftriaxone resistance among E. coli remained stable for the first 15 days of hospitalization and then increased. Ceftriaxone resistance among K. pneumoniae and S. marcescens and oxacillin resistance among S. aureus increased linearly during the hospitalization. Cefepime resistance among P. aeruginosa remained stable during the hospitalization. Discussion: We showed that hospitalization duration is associated with a species- and antibiotic class-dependent pattern of antimicrobial resistance.
AB - Objectives: Changing microorganism distributions and decreasing antibiotic susceptibility with increasing length of hospital stay have been demonstrated for the colonization or infection of selected organ systems. We wanted to describe microorganism distribution or antibiotic resistance in bacteraemia according to duration of the hospitalization using a large national epidemiological/microbiological database (ANRESIS) in Switzerland. Methods: We conducted a nationwide, observational study on bacteraemia using ANRESIS data from 1 January 2008 to 31 December 2017. We analysed data on bacteraemia from those Swiss hospitals that sent information on a regular basis during the entire study period. We described the pathogen distribution and specific trends of resistance during hospitalization for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Serratia marcescens and Staphylococcus aureus. Results: We included 28 318 bacteraemia isolates from 90 Swiss hospitals. The most common aetiology was E. coli (33.4%, 9459), followed by S. aureus (16.7%, 4721), K. pneumoniae (7.1%, 2005), Enterococcus faecalis (5.2%, 1473), P. aeruginosa (4.3%, 1228), Streptococcus pneumoniae (4.3%, 1208) and Enterococcus faecium (3.9%, 1101). We observed 489 (1.73%) S. marcescens isolates. We observed an increasing trend for E. faecium (from 1.5% at day 0 to 13.7% at day 30; p < 0.001), K. pneumoniae (from 6.1% to 7.8%, p < 0.001) and P. aeruginosa (from 2.9% to 13.7%, p < 0.001) with increasing duration of hospitalization; and decreasing trends for E. coli (from 41.6% to 21.6%; p < 0.001) and S. aureus (p < 0.001). Ceftriaxone resistance among E. coli remained stable for the first 15 days of hospitalization and then increased. Ceftriaxone resistance among K. pneumoniae and S. marcescens and oxacillin resistance among S. aureus increased linearly during the hospitalization. Cefepime resistance among P. aeruginosa remained stable during the hospitalization. Discussion: We showed that hospitalization duration is associated with a species- and antibiotic class-dependent pattern of antimicrobial resistance.
KW - Bacteraemia
KW - Bloodstream infection
KW - Hospitalization duration
KW - Length of stay
KW - Microorganism
KW - Resistance
UR - http://www.scopus.com/inward/record.url?scp=85106940464&partnerID=8YFLogxK
U2 - 10.1016/j.cmi.2021.04.025
DO - 10.1016/j.cmi.2021.04.025
M3 - Article
C2 - 33933567
AN - SCOPUS:85106940464
VL - 27
SP - 1820
EP - 1825
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
SN - 1198-743X
IS - 12
ER -