1. Revisiting the epidemiology of bloodstream infections and healthcare-associated episodes: results from a multicentre prospective cohort in Spain (PRO-BAC Study)
- Author
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Carmen Herrero Rodríguez, Clara Natera Kindelán, Teresa Marrodan Ciordia, Marcos Guzmán García, Juan Sevilla Blanco, Lucía Boix-Palop, Carlos Armiñanzas Castillo, Adrian Sousa Domínguez, Luis Eduardo López-Cortés, Alfredo Jover Saenz, Alberto Bahamonde-Carrasco, María Ángeles Mantecon Vallejo, Isabel María Reche Molina, María Luisa Cantón-Bulnes, José María Reguera-Iglesias, Eva León Jiménez, Berta Becerril Carral, Inmaculada López-Hernández, Jesús Rodríguez-Baño, Alfonso Del Arco Jiménez, José Bravo-Ferrer, Joaquín Felipe Lanz-García, Esperanza Merino de Lucas, Antonio Sánchez-Porto, Josune Goikoetxea Aguirre, David Garcia, Inés Pérez Camacho, Fátima Galán-Sánchez, Jonathan Fernández Suárez, Pedro María Martínez Pérez-Crespo, Alejandro Smithson Amat, Jordi Cuquet Pedragosa, Instituto de Salud Carlos III, Ministerio de Ciencia, Innovación y Universidades (España), Red Española de Investigación en Patología Infecciosa, and European Commission
- Subjects
Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,Staphylococcus aureus ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,Epidemiology ,030106 microbiology ,Bacteremia ,Bloodstream infection ,Healthcare-associated ,Logistic regression ,Severity of Illness Index ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Interquartile range ,Klebsiella ,Internal medicine ,Escherichia coli ,medicine ,Humans ,Pharmacology (medical) ,Prospective Studies ,030212 general & internal medicine ,Aetiology ,Prospective cohort study ,Aged ,Aged, 80 and over ,Cross Infection ,business.industry ,Mortality rate ,General Medicine ,Middle Aged ,Confidence interval ,Community-Acquired Infections ,Infectious Diseases ,Spain ,Etiology ,Bacteraemia ,Female ,business - Abstract
PROBAC REIPI/GEIH-SEIMC/SAEI Group., The epidemiology of bloodstream infections (BSIs) is dynamic as it depends on microbiological, host and healthcare system factors. The aim of this study was to update the information regarding the epidemiology of BSIs in Spain considering the type of acquisition. An observational, prospective cohort study in 26 Spanish hospitals from October 2016 through March 2017 including all episodes of BSI in adults was performed. Bivariate analyses stratified by type of acquisition were performed. Multivariate analyses were performed by logistic regression. Overall, 6345 BSI episodes were included; 2510 (39.8%) were community-acquired (CA), 1661 (26.3%) were healthcare-associated (HCA) and 2056 (32.6%) hospital-acquired (HA). The 30-day mortality rates were 11.6%, 19.5% and 22.0%, respectively. The median age of patients was 71 years (interquartile range 60–81 years) and 3656 (58.3%; 95% confidence interval 57.1–59.6%) occurred in males. The proportions according to patient sex varied according to age strata. Escherichia coli (43.8%), Klebsiella spp. (8.9%), Staphylococcus aureus (8.9%) and coagulase-negative staphylococci (7.4%) were the most frequent pathogens. Multivariate analyses confirmed important differences between CA and HCA episodes, but also between HCA and HA episodes, in demographics, underlying conditions and aetiology. In conclusion, we have updated the epidemiological information regarding patients’ profiles, underlying conditions, frequency of acquisition types and aetiological agents of BSI in Spain. HCA is confirmed as a distinct type of acquisition., This work was financed by grants from Plan Nacional de I+D+i 2013–2016, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades [PI16/01432] and the Spanish Network for Research in Infectious Diseases (REIPI) [RD16/0016/0001; RD16/0016/0008], co‐financed by the European Development Regional Fund ‘A way to achieve Europe’, Operative program Intelligent Growth 2014–2020.
- Published
- 2021