INCIDENCE AND MICROBIOLOGICAL PROFILE OF BLOODSTREAM INFECTIONS AMONG PATIENTS ADMITTED TO JENIN GOVERNMENTAL HOSPITAL: A PROSPECTIVE STUDY
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Date
2023-11-16
Authors
Shadi Adel Yousef Musleh
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Abstract
Abstract
Introduction- Bloodstream infections (BSIs) occur when pathogens enter the patient circulating blood, this leads to serious complications, increase length of stay in hospital and increase mortality rate. The reported considerable BSI incidence rates worldwide are considered a challenge for world health.
Objectives- To determine the incidence of BSIs, to characterize BSI patients at Jenin hospital, determine the distribution of antibiotic use, study microbiological profile, antibiotic susceptibility, association with antibiotic resistance, clarify the causative source.
Methodology- The present study is a four month prospective cohort study conducted from October 2022- February 2023 in different wards of Jenin governmental hospital in the north of West Bank of Palestine. A total of 1495 blood cultures for 1190 patients were included in the study.
Results- The study showed that 152 (10.2%) positive blood cultures were detected among the total 1495 blood culture tests, which were included in the study. The incidence for BSIs was 132 cases per 100000 per year. Regarding the type of pathogen in the present study, 55.9% of positive results were Gram-negative and 43.4% were Gram- positive, the most common Gram-negative bacteria were Klebsiella spp (19.2% of all detected pathogens), E.coli (11.2%), and Pseudomonas spp (9.2%). In addition, Staphylococcus aureus (32.4%) was the predominantly isolated Gram-positive bacteria. Out of the isolated bacteria, 40% possessed different resistance phenotypes. There was a significant association between BSIs developing and diabetes mellitus (DM) (P=0.012), hypertension (HTN) (P=0.036), and dialysis (P=0.000). Ceftriaxone (32.8%) was the most common antibiotic used for infected group and it was the most common antibiotic (31%) used for all suspected BSIs. The most effective antibiotic used for Gram-positive bacteria was vancomycin (100%). The most effective antibiotic used for Gram-negative was colistin (100%). Furthermore, the infected group was shown to have a significantly longer hospital stay (9.6 days) in comparison to non-infected group (6.5 days;P=0.000). Those who acquired BSIs had a significantly (P=0.000) higher mortality rate (22.5%) than that of non-infected group (11%).
Conclusion- Relentless effort should be given to develop infection control policies and programs within hospitals. There must be development of antibiotic stewardship program because of high rate of detection of MDROs.
Keywords: Bloodstream infection, Demographic data, Inflammatory marker, Antibiotic resistance, Etiological agent