Microbial Distribution and Antibiotic Susceptibility of Bloodstream Infections in Different Intensive Care

Abstract

\n Background: Bloodstream infection (BSI) is an increasing public health concern worldwide, representing a serious infection with significant morbidity and mortality, especially in children and elderly. The predominant microbial distribution and antibiotic susceptibility were investigated among BSIs in the pediatric intensive care unit (PICU), surgical intensive care unit (SICU), cardiac intensive care unit (CICU), respiratory intensive care unit (RICU) and geriatric intensive care unit (GICU) in order to achieve more efficient and appropriate therapies for patients in various ICUs.Methods: In this retrospective cross-sectional study, 516 positive cultures out of 6597 （positive rate 7.82%）blood specimens among BSIs in the five ICUs from 2017 to 2020 were analyzed for pathogen incidence and drug-susceptibility.Results: The incidence of BSIs was the highest in the RICU (9.48%) followed by the PICU (8.36%). The total prevalence of Gram-positive (G+) bacterial strains (especially Staphylococcus spp. and Enterococcus spp.) in the PICU (44.55%), SICU (57.58%), CICU (55.00%) and GICU (49.06%) was higher than Gram-negative (G-) bacteria. The major bacterial strain was Acinetobacter baumannii (G-) in the PICU (21.82%), Klebsiella pneumoniae (G-) in the SICU (12.88%), CICU (30.00%) and RICU (30.39%), and Escherichia coli (G-) in GICU (20.75%). Staphylococcus hominis of BSIs remained highly susceptible (>70%) to gentamicin, linezolid, daptomycin, teicoplanin, vancomycin, tigecycline and rifampicin in all the ICUs. Its antibiotic sensitivity to levofloxacin was moderate in the PICU and CICU, but mild (<30%) in the SICU, RICU and GICU. K. pneumoniae was highly susceptible to doxycycline, minocycline, tigecycline in all the ICUs except RICU, and its antibiotic sensitivity to imipenem, meropenem, amikacin, ciprofloxacin and levofloxacin in the GICU was high/moderate in PICU, CICU and GICU, but mild in the SICU and RICU.Conclusions: The current study demonstrated the distribution of prevalent microorganisms and their antimicrobial susceptibility exhibited a high divergence among BSIs in PICU, SICU, CICU, RICU and GICU from a tertiary hospital in Beijing. Therefore, different antibiotic therapies for various wards and distinct age groups (especially between pediatric and elderly patients) should be considered to control the emergence and spread of highly antibiotic-resistant infections.