AUTHOR=Hu Fupin , Yuan Lili , Yang Yang , Xu Yuanhong , Huang Ying , Hu Yunjian , Ai Xiaoman , Zhuo Chao , Su Danhong , Shan Bin , Du Yan , Yu Yunsong , Lin Jie , Sun Ziyong , Chen Zhongju , Xu Yingchun , Zhang Xiaojiang , Wang Chuanqing , He Leiyan , Ni Yuxing , Zhang Yibo , Lin Dongfang , Zhu Demei , Zhang Yingyuan 

TITLE=A multicenter investigation of 2,773 cases of bloodstream infections based on China antimicrobial surveillance network (CHINET)

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2022.1075185

DOI=10.3389/fcimb.2022.1075185

ISSN=2235-2988

ABSTRACT=Abstract
Background. Bloodstream infections (BSIs), especially hospital-acquired BSIs, are major cause of morbidity and mortality. However, the details about the pathogens and antimicrobial resistance profile of BSIs across China are still lacking.
Methods. An investigation was conducted in 10 large teaching hospitals from 7 geographic regions across China in 2016 based on China Antimicrobial Resistance Surveillance Network (CHINET) to profile the clinical and etiological features of BSIs.
Results. A total of 2,773 cases of BSIs were identified, majority (97.3%) of which were monomicrobial. Overall, 38.4% (1,065/2,773) were community-acquired BSIs (CABSIs), and 61.6% (1,708/2,773) were hospital-acquired BSIs (HABSIs). Of the 2,861 pathogenic BSI isolates, 67.5% were gram-negative bacteria, 29.6% gram-positive bacteria, and 2.9% fungi. The top BSI pathogens were E. coli, Klebsiella. pneumoniae, coagulase-negative Staphylococcus (CNS), S. aureus, Enterococcus, and A. baumannii. E. coli and K. pneumoniae isolates showed low susceptibility to penicillins, cephalosporins, and ampicillin-sulbactam (13.1% to 43.4% susceptible), moderate susceptibility (about 60% susceptible) to ceftazidime, cefepime, and aztreonam, and high susceptibility (> 90%) to -lactam/-lactamase inhibitor combinations other than ampicillin-sulbactam except K. pneumoniae strains to piperacillin-tazobactam (59.2% susceptible). HABSIs were associated with significantly higher prevalence of carbapenem-resistant and extended-spectrum β-Lactamases-producing K. pneumoniae, methicillin-resistant S. aureus, methicillin-resistant CNS, and ampicillin-resistant Enterococcus than CABSIs. Overall, 42.0% of the BSI due to S. aureus strains were resistant to methicillin.
Conclusions. The findings about BSIs in teaching hospitals across China add more scientific evidence to inform the appropriate management of the disease.