Clinical-laboratory characteristics and etiological structure of bloodstream infections: results of a multicenter clinical study

Abstract

The aim of the study was to assess the etiological structure of bloodstream infections in different pathological conditions and to determine the sensitivity of their pathogens to antibiotics.

Material and methods. A multicenter clinical investigation was carried out to analyze 5892 clinical blood samples from patients with different pathological conditions, who were hospitalized in multi-disciplinary medical and preventive healthcare organizations. Microbiological blood examination for sterility was carried out by the classical bacteriological method using a two-phase medium or using an automatic hemocultivator. Identification of isolated hemocultures and determination of their sensitivity to antibiotics was performed by using means of an automatic microbiological analyzer.

Results and discussion. A total of 789 clinically significant hemocultures were isolated, including 471 (59.7%) strains of gram-positive bacteria, 290 (36.8%) strains of gram-negative bacteria and 28 (3.5%) strains of Candida fungi. The number of positive results was 13.4%, and it was 1.4 times higher when using a hemocultivator compared with manual testing (17.9 and 12.6% respectively). The predominance of coagulase-negative staphylococci in patients with lower respiratory tract infections (45.5%), fever of unknown etiology (40.5%), surgical site infections (34.5%), thermal and chemical burns (45.8%), endocarditis (34.5%) has been shown. Enterobacteria were isolated with higher frequency in bacteremia in patients with malignant tumors (43.5%), urinary tract infections (30.8%), sepsis (39.2%). Gram-negative non-fermenting bacteria (Pseudomonas aeruginosa, Acinetobacter spp.) were isolated with the greatest frequency in patients with oncopathology (19.6%), burn disease (27.1%), infectious endocarditis (27.6%). High levels of resistance of invasive strains of K. pneumoniae, A. baumannii, P. aeruginosa to carbapenems, cephalosporins of III-IV generation, aminoglycosides, fluoroquinolones have been shown.

Conclusion. The increased role of K. pneumoniae and gram-negative non-fermenting bacteria in the etiology of bloodstream infections and also high levels of their resistance to antibiotics were noted. The high efficiency and rate of performing microbiological research using an automatic analyzer for hemoculture in comparison with the traditional manual method has been shown.

Keywords:bloodstream infections, hemoculture, bacteremia

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Research concept and design, text writing, editing - Tapalski D.V., Stoma I.O.; material collection and processing, statistical processing, text writing - Bonda N.A.

For citation: Bonda N.A., Tapalski D.V., Stoma I.O. Clinical-laboratory characteristics and etiological structure of bloodstream infections: results of a multicenter clinical study. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2021; 10 (1): 54-9. DOI: https://doi.org/10.33029/2305-3496-2021-10-2-54-59 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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