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Antibiotic resistance of blood cultures in regional and tertiary hospital settings of Tyrol, Austria (2006-2015): Impacts & trends.

ABSTRACT: Blood stream infections rank among the top seven causes of death of the general population. The aim of our study was to better understand the epidemiology of BSI in order to improve diagnostics and patient outcome. We used retrospective aggregated laboratory data of blood samples received from all public hospitals in Tyrol, Austria between 2006 and 2015. Microorganisms were categorized into obligatory, facultative, unusual pathogens and contaminants. The distribution, the cumulative incidence and antimicrobial susceptibility patterns were compared between the tertiary (TH) and regional peripheral hospitals (PH). Among 256,364 blood samples, 76.1% were from the TH The incidence of obligatory pathogens was 1.7 fold, and up to 3 times higher for facultative, unusual pathogens and contaminants in the TH and increased mainly due to an increase of E.coli, which was the most common isolated pathogen (n = 2,869), followed by Staphylococcus aureus (n = 1,439), Enterococcus sp. (n = 953) and Klebsiella sp. (n = 816). The distribution of obligatory pathogens differed between the hospital settings: In the TH Enterococcus sp. accounted for 40.8% and E.coli for 70.4%, respectively, whereas in the PH for 25.4% (p<0.0001) and 57.8%, respectively (p<0.0001) Antibiotic resistance of Gram negative bacteria and Staphylococcus aureus did not change during the observation period. Carbapenem resistance of Klebsiella sp. and vancomycin and linezolid resistance of Enterococcus faecium showed a non-significant increase since 2010 in the TH setting. We concluded that the incidence of BSI in TH was higher compared to PH. We observed higher contamination rates in the TH. We could not interpret the data of coagulase negative staphylococci due to lack of clinical data. We strongly recommend enhancement of training on blood culture sampling to decrease the rate of contamination. Due to differences in pathogen distribution and antimicrobial resistance between different hospital settings we recommend separate treatment guidelines for BSI by hospital setting.

SUBMITTER: Kreidl P

PROVIDER: S-EPMC6786751 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Antibiotic resistance of blood cultures in regional and tertiary hospital settings of Tyrol, Austria (2006-2015): Impacts & trends.

Kreidl Peter P Kirchner Thomas T Fille Manfred M Heller Ingrid I Lass-Flörl Cornelia C Orth-Höller Dorothea D

PloS one 20191010 10

Blood stream infections rank among the top seven causes of death of the general population. The aim of our study was to better understand the epidemiology of BSI in order to improve diagnostics and patient outcome. We used retrospective aggregated laboratory data of blood samples received from all public hospitals in Tyrol, Austria between 2006 and 2015. Microorganisms were categorized into obligatory, facultative, unusual pathogens and contaminants. The distribution, the cumulative incidence an ...[more]

PMID: 31600293

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Project description:BackgroundHomicide presents a significant health burden globally, but geographical differences in homicide rates necessitate focussed analyses of spatial and temporal patterns, particularly in affected areas. The highest rates are concentrated in regions in Central and South America, but analyses of sub-regional patterns and sex-specific differences may yield important information for addressing the upstream causes of homicide at the community level.ObjectiveThis study examines and presents spatial and temporal patterns of homicide victims from 2006 to 2015 in the state of Alagoas, Brazil, focussing on the municipality scale and differentiated by victims' sex.MethodsData comprising victims' age, sex, the date, time, and the municipality of the homicide incident were acquired from the Brazilian National Mortality Information System. These data were aggregated by municipality, and we made quantitative comparisons of sex-specific homicide rates between the capital city of Macieó metropolitan region and the peripheral, predominantly rural regions. Empirical Local Bayes methods were used to adjust per-capita homicide risk estimates and map the results.ResultsA total of 19,560 homicides occurred during the study period, with an average of 60.4 per 100,000 inhabitants; the metropolitan region rate was 81.8, compared to 46.5 for the remaining regions. The male homicide rate was 115.9 per 100,000, compared to 7.1 for females. Empirical Local Bayes mapping showed strong clustering of male homicide risk in specific cities near the capital, while female risk was more dispersed throughout the region.ConclusionsThe risk of male victim homicide observed for the metropolitan region of Alagoas was amongst the highest globally, particularly during the period 2012-2014. Geographical differences in male and female risk may indicate differences in risk factors and highlight a need for prevention programmes that take into account gender-specific pathways of violence.

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Dataset Information

Antibiotic resistance of blood cultures in regional and tertiary hospital settings of Tyrol, Austria (2006-2015): Impacts & trends.

Publications

Antibiotic resistance of blood cultures in regional and tertiary hospital settings of Tyrol, Austria (2006-2015): Impacts & trends.

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