The Microbiology of Bloodstream Infection: 20-Year Trends from the SENTRY Antimicrobial Surveillance Program
Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory. Bloodstream...
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| Published in | Antimicrobial agents and chemotherapy Vol. 63; no. 7 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
American Society for Microbiology
01.07.2019
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0066-4804 1098-6596 1098-6596 |
| DOI | 10.1128/AAC.00355-19 |
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| Abstract | Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory.
Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory. Clinical data and isolates from 264,901 BSI episodes were collected. The most common pathogen overall was
Staphylococcus aureus
(20.7%), followed by
Escherichia coli
(20.5%),
Klebsiella pneumoniae
(7.7%),
Pseudomonas aeruginosa
(5.3%), and
Enterococcus faecalis
(5.2%).
S. aureus
was the most frequently isolated pathogen overall in the 1997-to-2004 period, but
E. coli
was the most common after 2005. Pathogen frequency varied by geographic region, hospital-onset or community-onset status, and patient age. The prevalence of
S. aureus
isolates resistant to oxacillin (ORSA) increased until 2005 to 2008 and then declined among hospital-onset and community-acquired BSI in all regions. The prevalence of vancomycin-resistant enterococci (VRE) was stable after 2012 (16.4% overall). Daptomycin resistance among
S. aureus
and enterococci (DRE) remained rare (<0.1%). In contrast, the prevalence of multidrug-resistant (MDR)
Enterobacteriaceae
increased from 6.2% in 1997 to 2000 to 15.8% in 2013 to 2016. MDR rates were highest among nonfermentative Gram-negative bacilli (GNB), and colistin was the only agent with predictable activity against
Acinetobacter baumannii-Acinetobacter calcoaceticus
complex (97% susceptible). In conclusion,
S. aureus
and
E. coli
were the predominant causes of BSI worldwide during this 20-year surveillance period. Important resistant phenotypes among Gram-positive pathogens (MRSA, VRE, or DRE) were stable or declining, whereas the prevalence of MDR-GNB increased continuously during the monitored period. MDR-GNB represent the greatest therapeutic challenge among common bacterial BSI pathogens. |
|---|---|
| AbstractList | Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory.
Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory. Clinical data and isolates from 264,901 BSI episodes were collected. The most common pathogen overall was
Staphylococcus aureus
(20.7%), followed by
Escherichia coli
(20.5%),
Klebsiella pneumoniae
(7.7%),
Pseudomonas aeruginosa
(5.3%), and
Enterococcus faecalis
(5.2%).
S. aureus
was the most frequently isolated pathogen overall in the 1997-to-2004 period, but
E. coli
was the most common after 2005. Pathogen frequency varied by geographic region, hospital-onset or community-onset status, and patient age. The prevalence of
S. aureus
isolates resistant to oxacillin (ORSA) increased until 2005 to 2008 and then declined among hospital-onset and community-acquired BSI in all regions. The prevalence of vancomycin-resistant enterococci (VRE) was stable after 2012 (16.4% overall). Daptomycin resistance among
S. aureus
and enterococci (DRE) remained rare (<0.1%). In contrast, the prevalence of multidrug-resistant (MDR)
Enterobacteriaceae
increased from 6.2% in 1997 to 2000 to 15.8% in 2013 to 2016. MDR rates were highest among nonfermentative Gram-negative bacilli (GNB), and colistin was the only agent with predictable activity against
Acinetobacter baumannii-Acinetobacter calcoaceticus
complex (97% susceptible). In conclusion,
S. aureus
and
E. coli
were the predominant causes of BSI worldwide during this 20-year surveillance period. Important resistant phenotypes among Gram-positive pathogens (MRSA, VRE, or DRE) were stable or declining, whereas the prevalence of MDR-GNB increased continuously during the monitored period. MDR-GNB represent the greatest therapeutic challenge among common bacterial BSI pathogens. Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory. Clinical data and isolates from 264,901 BSI episodes were collected. The most common pathogen overall was Staphylococcus aureus (20.7%), followed by Escherichia coli (20.5%), Klebsiella pneumoniae (7.7%), Pseudomonas aeruginosa (5.3%), and Enterococcus faecalis (5.2%). S. aureus was the most frequently isolated pathogen overall in the 1997-to-2004 period, but E. coli was the most common after 2005. Pathogen frequency varied by geographic region, hospital-onset or community-onset status, and patient age. The prevalence of S. aureus isolates resistant to oxacillin (ORSA) increased until 2005 to 2008 and then declined among hospital-onset and community-acquired BSI in all regions. The prevalence of vancomycin-resistant enterococci (VRE) was stable after 2012 (16.4% overall). Daptomycin resistance among S. aureus and enterococci (DRE) remained rare (<0.1%). In contrast, the prevalence of multidrug-resistant (MDR) Enterobacteriaceae increased from 6.2% in 1997 to 2000 to 15.8% in 2013 to 2016. MDR rates were highest among nonfermentative Gram-negative bacilli (GNB), and colistin was the only agent with predictable activity against Acinetobacter baumannii-Acinetobacter calcoaceticus complex (97% susceptible). In conclusion, S. aureus and E. coli were the predominant causes of BSI worldwide during this 20-year surveillance period. Important resistant phenotypes among Gram-positive pathogens (MRSA, VRE, or DRE) were stable or declining, whereas the prevalence of MDR-GNB increased continuously during the monitored period. MDR-GNB represent the greatest therapeutic challenge among common bacterial BSI pathogens.Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory. Clinical data and isolates from 264,901 BSI episodes were collected. The most common pathogen overall was Staphylococcus aureus (20.7%), followed by Escherichia coli (20.5%), Klebsiella pneumoniae (7.7%), Pseudomonas aeruginosa (5.3%), and Enterococcus faecalis (5.2%). S. aureus was the most frequently isolated pathogen overall in the 1997-to-2004 period, but E. coli was the most common after 2005. Pathogen frequency varied by geographic region, hospital-onset or community-onset status, and patient age. The prevalence of S. aureus isolates resistant to oxacillin (ORSA) increased until 2005 to 2008 and then declined among hospital-onset and community-acquired BSI in all regions. The prevalence of vancomycin-resistant enterococci (VRE) was stable after 2012 (16.4% overall). Daptomycin resistance among S. aureus and enterococci (DRE) remained rare (<0.1%). In contrast, the prevalence of multidrug-resistant (MDR) Enterobacteriaceae increased from 6.2% in 1997 to 2000 to 15.8% in 2013 to 2016. MDR rates were highest among nonfermentative Gram-negative bacilli (GNB), and colistin was the only agent with predictable activity against Acinetobacter baumannii-Acinetobacter calcoaceticus complex (97% susceptible). In conclusion, S. aureus and E. coli were the predominant causes of BSI worldwide during this 20-year surveillance period. Important resistant phenotypes among Gram-positive pathogens (MRSA, VRE, or DRE) were stable or declining, whereas the prevalence of MDR-GNB increased continuously during the monitored period. MDR-GNB represent the greatest therapeutic challenge among common bacterial BSI pathogens. Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory. Clinical data and isolates from 264,901 BSI episodes were collected. The most common pathogen overall was Staphylococcus aureus (20.7%), followed by Escherichia coli (20.5%), Klebsiella pneumoniae (7.7%), Pseudomonas aeruginosa (5.3%), and Enterococcus faecalis (5.2%). S. aureus was the most frequently isolated pathogen overall in the 1997-to-2004 period, but E. coli was the most common after 2005. Pathogen frequency varied by geographic region, hospital-onset or community-onset status, and patient age. The prevalence of S. aureus isolates resistant to oxacillin (ORSA) increased until 2005 to 2008 and then declined among hospital-onset and community-acquired BSI in all regions. The prevalence of vancomycin-resistant enterococci (VRE) was stable after 2012 (16.4% overall). Daptomycin resistance among S. aureus and enterococci (DRE) remained rare (<0.1%). In contrast, the prevalence of multidrug-resistant (MDR) Enterobacteriaceae increased from 6.2% in 1997 to 2000 to 15.8% in 2013 to 2016. MDR rates were highest among nonfermentative Gram-negative bacilli (GNB), and colistin was the only agent with predictable activity against Acinetobacter baumannii-Acinetobacter calcoaceticus complex (97% susceptible). In conclusion, S. aureus and E. coli were the predominant causes of BSI worldwide during this 20-year surveillance period. Important resistant phenotypes among Gram-positive pathogens (MRSA, VRE, or DRE) were stable or declining, whereas the prevalence of MDR-GNB increased continuously during the monitored period. MDR-GNB represent the greatest therapeutic challenge among common bacterial BSI pathogens. Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory. Clinical data and isolates from 264,901 BSI episodes were collected. The most common pathogen overall was (20.7%), followed by (20.5%), (7.7%), (5.3%), and (5.2%). was the most frequently isolated pathogen overall in the 1997-to-2004 period, but was the most common after 2005. Pathogen frequency varied by geographic region, hospital-onset or community-onset status, and patient age. The prevalence of isolates resistant to oxacillin (ORSA) increased until 2005 to 2008 and then declined among hospital-onset and community-acquired BSI in all regions. The prevalence of vancomycin-resistant enterococci (VRE) was stable after 2012 (16.4% overall). Daptomycin resistance among and enterococci (DRE) remained rare (<0.1%). In contrast, the prevalence of multidrug-resistant (MDR) increased from 6.2% in 1997 to 2000 to 15.8% in 2013 to 2016. MDR rates were highest among nonfermentative Gram-negative bacilli (GNB), and colistin was the only agent with predictable activity against complex (97% susceptible). In conclusion, and were the predominant causes of BSI worldwide during this 20-year surveillance period. Important resistant phenotypes among Gram-positive pathogens (MRSA, VRE, or DRE) were stable or declining, whereas the prevalence of MDR-GNB increased continuously during the monitored period. MDR-GNB represent the greatest therapeutic challenge among common bacterial BSI pathogens. |
| Author | Pfaller, Michael A. Rolston, Kenneth V. Hsueh, Po-Ren Sader, Helio S. Jones, Ronald N. Diekema, Daniel J. Mendes, Rodrigo E. |
| Author_xml | – sequence: 1 givenname: Daniel J. surname: Diekema fullname: Diekema, Daniel J. organization: University of Iowa, Iowa City, Iowa, USA – sequence: 2 givenname: Po-Ren surname: Hsueh fullname: Hsueh, Po-Ren organization: National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan – sequence: 3 givenname: Rodrigo E. surname: Mendes fullname: Mendes, Rodrigo E. organization: JMI Laboratories, North Liberty, Iowa, USA – sequence: 4 givenname: Michael A. surname: Pfaller fullname: Pfaller, Michael A. organization: University of Iowa, Iowa City, Iowa, USA, JMI Laboratories, North Liberty, Iowa, USA – sequence: 5 givenname: Kenneth V. surname: Rolston fullname: Rolston, Kenneth V. organization: The University of Texas MD Anderson Cancer Center, Houston, Texas, USA – sequence: 6 givenname: Helio S. surname: Sader fullname: Sader, Helio S. organization: JMI Laboratories, North Liberty, Iowa, USA – sequence: 7 givenname: Ronald N. surname: Jones fullname: Jones, Ronald N. organization: JMI Laboratories, North Liberty, Iowa, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31010862$$D View this record in MEDLINE/PubMed |
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| Keywords | antimicrobial resistance bloodstream infection surveillance |
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| SubjectTerms | Acinetobacter baumannii - drug effects Acinetobacter baumannii - isolation & purification Acinetobacter Infections - epidemiology Acinetobacter Infections - microbiology Anti-Bacterial Agents - pharmacology Bacteremia Bacteremia - epidemiology Bacteremia - microbiology Community-Acquired Infections - epidemiology Community-Acquired Infections - microbiology Drug Resistance, Bacterial - drug effects Enterococcus faecalis - drug effects Enterococcus faecalis - isolation & purification Epidemiology and Surveillance Europe - epidemiology Gram-Positive Bacterial Infections - epidemiology Gram-Positive Bacterial Infections - microbiology Humans Klebsiella Infections - epidemiology Klebsiella Infections - microbiology Klebsiella pneumoniae - drug effects Klebsiella pneumoniae - isolation & purification Latin America - epidemiology Microbial Sensitivity Tests Pseudomonas aeruginosa - drug effects Pseudomonas aeruginosa - isolation & purification Pseudomonas Infections - epidemiology Pseudomonas Infections - microbiology Staphylococcal Infections - epidemiology Staphylococcal Infections - microbiology Staphylococcus aureus - drug effects Staphylococcus aureus - isolation & purification |
| Title | The Microbiology of Bloodstream Infection: 20-Year Trends from the SENTRY Antimicrobial Surveillance Program |
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