The burden of bacteremic and non-bacteremic Gram-negative infections: A prospective multicenter cohort study in a low-resistance country.

Autor: Deelen JWT; Julius Center for Health Sciences and Primary Care, Huispostnummer STR 6.131, Postbus 85500, 3508 GA Utrecht, the Netherlands. Electronic address: j.w.t.deelen@umcutrecht.nl., Rottier WC; Julius Center for Health Sciences and Primary Care, Huispostnummer STR 6.131, Postbus 85500, 3508 GA Utrecht, the Netherlands., van Werkhoven CH; Julius Center for Health Sciences and Primary Care, Huispostnummer STR 6.131, Postbus 85500, 3508 GA Utrecht, the Netherlands., Woudt SHS; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands., Buiting AGM; Laboratory for Medical Microbiology and Immunology, Elisabeth-TweeSteden Hospital, Tilburg/Waalwijk, the Netherlands., Dorigo-Zetsma JW; Central Laboratory for Bacteriology and Serology, the Netherlands., Kluytmans JAJW; Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands., van der Linden PD; Department of Clinical Pharmacy, Tergooi Hospitals, Hilversum, the Netherlands., Thijsen SFT; Department of Medical Microbiology and Immunology, Diakonessenhuis, Utrecht, the Netherlands., Vlaminckx BJM; Department of Medical Microbiology and Immunology, St. Antonius Hospital, Utrecht/Nieuwegein, the Netherlands., Weersink AJL; Laboratory for Medical Microbiology and Immunology, Meander Medical Center, Amersfoort, the Netherlands., Ammerlaan HSM; Julius Center for Health Sciences and Primary Care, Huispostnummer STR 6.131, Postbus 85500, 3508 GA Utrecht, the Netherlands; Department of Internal Medicine, Catharina Hospital, Eindhoven, the Netherlands., Bonten MJM; Julius Center for Health Sciences and Primary Care, Huispostnummer STR 6.131, Postbus 85500, 3508 GA Utrecht, the Netherlands; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Jazyk: angličtina
Zdroj: The Journal of infection [J Infect] 2020 Dec; Vol. 81 (6), pp. 895-901. Date of Electronic Publication: 2020 Oct 06.
DOI: 10.1016/j.jinf.2020.10.001
Abstrakt: Objectives There is a global increase in infections caused by Gram-negative bacteria. The majority of research is on bacteremic Gram-negative infections (GNI), leaving a knowledge gap on the burden of non-bacteremic GNI. Our aim is to describe characteristics and determine the burden of bacteremic and non-bacteremic GNI in hospitalized patients in the Netherlands. Methods We conducted a prospective cohort study of patients in eight hospitals with microbiologically confirmed GNI, between June 2013 and November 2015. In each hospital the first five adults meeting the eligibility criteria per week were enrolled. We estimated the national incidence and mortality of GNI by combining the cohort data with a national surveillance database for antimicrobial resistance. Results 1,954 patients with GNI were included of which 758 (39%) were bloodstream infections (BSI). 243 GNI (12%) involved multi-drug resistant pathogens. 30-day mortality rate was 11.1% (n = 217) Estimated national incidences of non-bacteremic GNI and bacteremic GNI in hospitalized adults were 74 (95% CI 58 - 89) and 86 (95% CI 72-100) per 100,000 person years, yielding estimated annual numbers of 30-day all-cause mortality deaths of 1,528 (95% CI 1,102-1,954) for bacteremic and 982 (95% CI 688 - 1,276) for non-bacteremic GNI. Conclusion GNI form a large mortality burden in a low-resistance country. A third of the associated mortality occurs after non-bacteremic GNI.
Competing Interests: Conflicts of Interest None reported.
(Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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