Bloodstream Infections in the Intensive Care Unit: a Single-Center Retrospective Bacteriological Analysis Between 2007 and 2019

Aneta Guzek; Zbigniew Rybicki; Agnieszka Woźniak-kosek; Dariusz Tomaszewski

doi:10.33073/pjm-2022-025

Figures & Tables

Trends in pathogens isolated between 2007 and 2019.

Gram-positive alert pathogens with mechanisms of resistance, isolated between 2009 and 2019.

Gram-negative alert pathogens with mechanisms of resistance, isolated between 2009 and 2019.

Descriptive statistics of the study population and their primary diagnoses according to ICD10_

		Year
		2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019
Patients	n	197	182	216	173	224	178	172	186	350	422	422	450	348
Age	median	53	54	60	59	49	43	45	49	43	43	52	57	53
	minimum	18	18	18	21	19	18	18	15	19	18	19	21	24
	maximum	84	86	87	87	82	87	82	91	87	85	87	85	88
	Q1-Q3	42-69	29-74	42-71	44-75	37-65	28-59	28-67	37-62	27-63	29-57	40-67	38-69	37-63
Hospitalization time in ICU (days)	median	22	26	16	30	17	20	23	14	16	15	14	14	8
	minimum	1	1	1	1	1	1	1	1	1	1	1	1	1
	maximum Q1-Q3	136 11–47	147 9-48	124 7-27	137 11–58	48 5-27	107 11-31	106 10-36	273 8-39	126 8–31	275 7-35	205 5-36	159 5-32	238 24
Deaths	n (%)	71 (36%)	62 (34%)	68 (31%)	57 (33%)	83 (37%)	60 (34%)	56 (33%)	64 (34%)	135(39%)	117(28%)	166 (39%)	160 (36%)	149 (43%)
			Main diagnosis according to ICD10
								Year
		2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019
Other bacterial diseases [A30–A49]¹		4	4	6	3	6	3	4	4	8	11	13	12	10
Malignant [C00–C14]neoplasms ² of lip, oral cavity, and pharynx		3	5	3	4	4	3	4	3	4	4	3	5	4
Malignant neoplasms of digestive organs [C15–C26]³		0	1	2	0	0	0	0	0	0	1	0	0	0
Malignant organs [C30neoplasms –C39]⁴ of respiratory and intrathoracic		0	0	1	0	0	0	0	0	1	1	0	0	0
Malignant and related neoplasms tissue [C81of -lymphoid, C96]⁵ hematopoietic,		4	3	4	4	4	4	3	4	7	8	6	6	5
Diabetes mellitus [E10-E14]⁶		4	7	5	4	5	3	2	4	6	5	7	6	5
Obesity and other hyperalimentation [E65-E68]		0	0	1	0	1	0	0	0	2	2	3	3	1
Metabolic disorders⁷		4	2	3	0	1	0	1	1	3	0	3	4	2
Inflammatory system [G00–Gdiseases 09]⁸ of the central nervous		3	1	2	0	4	0	0	0	2	2	3	4	2
Systemic nervous system atrophies [Gprimarily 10–G14]⁹ affecting the central		0	0	1	0	0	0	0	0	0	0	0	0	0
Episodic and paroxysmal disorders [G40–G47]¹⁰		2	3	2	0	1	0	0	1	1	2	1	2	2
Diseases [G70–G73of ]myoneural ¹¹ junction and muscle		0	0	1	1	0	0	0	0	0	1	0	0	0
Cerebral [G80–G83palsy ]¹² and other paralytic syndromes		0	2	0	0	0	0	0	0	0	0	0	0	0
Other disorders of the nervous system [G90–G99]¹³		0	0	0	0	0	0	0	0	2	1	0	0	0
Ischemic heart diseases [I20–I25]¹⁴		3	3	4	0	3	2	2	2	4	6	6	5	4
Pulmonary circulation heart [I26–Idisease 28]¹⁵ and diseases of pulmonary		2	1	2	0	2	2	2	3	6	7	8	8	6
Other forms of heart disease [I30–I52]¹⁶		36	27	25	13	27	17	16	17	24	31	27	34	28
Cerebrovascular diseases [I60–I69]¹⁷		6	8	10	0	10	8	8	8	14	13	14	22	16
Diseases of arteries, arterioles, and capillaries [I70–I79]¹⁸		4	2	2	0	0	0	0	0	2	1	1	0	0
Diseases nodes [I80of –veins, I89]¹⁹ lymphatic vessels, and lymph		1	0	0	0	0	0	0	0	0	0	1	0	0
Influenza and pneumonia [J09-J18]²⁰		1	0	3	5	5	3	2	2	5	6	6	6	4
Chronic lower respiratory diseases [J40–J47]²¹		7	7	9	10	9	8	8	9	16	19	18	21	18
Lung diseases due to external agents [J60–J70]²²		5	4	5	0	2	2	1	1	1	3	3	4	2
Other the interstitium respiratory [Jdiseases 80–J84)²³ principally affecting		5	1	5	6	6	4	3	3	3	5	5	4	3
Suppurative respiratory tract and necrotic [J85–J86conditions ]²⁴ of the lower		0	1	0	0	0	0	0	0	0	2	0	1	0
Other diseases of the respiratory system [J95–J99]²⁵		21	10	19	44	38	28	22	19	25	30	28	37	27
Diseases [K20–K31of ]esophagus, ²⁶ stomach, and duodenum		5	4	4	2	2	2	1	0	2	4	5	6	0
Hernia [K40–K46]²⁷		0	0	1	1	2	0	0	0	1	1	0	0	2
Other diseases of the intestines [K55-K64]²⁸		0	0	1	2	1	1	0	0	2	3	4	3	1
Diseases of peritoneum [K65–K67]²⁹		5	8	10	11	13	9	11	9	16	16	14	16	10
Diseases of the liver [K70–K77]³⁰		0	0	1	0	0	1	0	1	2	2	3	3	0
Disorders [K80–K87of ]³¹ gallbladder, biliary tract, and pancreas		13	10	10	13	14	9	8	9	11	9	7	10	6
Other diseases of the digestive system [K90–K93]³²		0	0	0	0	0	0	1	1	0	0	3	2	0
Infections [L00–L08]of ³³ the skin and subcutaneous tissue		0	0	0	0	0	1	0	0	0	0	0	0	0
Systemic connective tissue disorders [M30 -M32]³⁴		0	0	0	0	0	0	0	0	0	1	0	0	0
Osteopathies and chondropathies [M80–M94]³⁵		0	0	0	0	0	0	0	0	0	0	0	1	0
Injuries to the head [S00–S09]³⁶		5	5	7	9	9	8	11	9	27	23	23	24	16
Injuries to the neck [S10–S19]³⁷		0	0	0	4	0	2	3	0	2	0	0	2	0
Injuries to the thorax [S20–S29]³⁸		4	3	3	2	0	2	0	4	7	3	8	4	2
Injuries and pelvis to the [S30abdomen, –S39]³⁹ lower back, lumbar spine,		2	3	3	4	4	2	0	2	10	17	23	17	9
Injuries to the shoulder and upper arm [S40–S49]⁴⁰		0	0	0	0	0	1	0	0	0	1	0	0	0
Injuries to the hip and thigh [S70–S79]⁴¹		0	0	0	0	0	0	0	0	2	2	0	0	2
Injuries to the knee and lower leg [S80–S89]⁴²		0	0	1	0	0	0	0	0	0	2	0	1	0
Injuries involving multiple body regions [T00–T07]⁴³		44	45	53	21	32	41	48	57	101	142	145	141	134
Burns and corrosions [T20–T32]⁴⁴		4	9	6	9	16	10	11	11	19	31	29	35	26
Poisoning substances by [Tdrugs, 36–T50medicaments, ]⁴⁵ and biological		0	2	1	1	2	2	0	2	1	3	2	1	0
Other [T66-Tand 78]unspecified ⁴⁶ effects of external causes		0	1	0	0	1	0	0	0	1	1	0	0	1

The number of microbiological analyses, with their results, performed between 2007 and 2019_

	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019
Beds in ICU (n)	8	8	8	8	8	8	8	14	18	18	18	18	18
Hospitalizations (n)	179	182	216	173	224	178	172	186	350	422	422	450	348
Microbiological analyses (n)	2,361	2,349	2,710	2,454	3,123	2,796	2,797	2,811	4,093	5,376	5,030	5,089	5,264
Microbiological of blood samples analyses (n)	670	613	785	641	1,245	1,016	944	831	1,219	1,326	988	1,161	1,180
Blood analyses, microbiological negative results (n)	548	473	632	534	1,130	889	809	690	1,064	1,140	858	1,023	994
Blood analyses, microbiological positive results (n)	107	120	135	97	104	99	106	112	120	154	104	106	145
Blood microbiological analyses, contaminated samples (n)	15	20	18	10	11	28	29	29	35	32	26	32	41
Microbiological of the tip of the analyses catheter (n)	30	23	28	18	39	29	45	53	70	70	76	77	65
Microbiological analyses of the tip of the catheter, positive results (n)	13	11	17	12	21	11	31	30	20	29	31	26	26

The number of pathogens isolated from blood samples between 2007 and 2019_

Pathogen (mechanism of Pathogen antibiotic resistance)		2007	2008	2009	2010	2011	2011	2012	2013	2014	2015	2016	2017	2018	Total
Gram-negative bacilli	Acinetobacter baumannii	33	24	22	19	38	26	25	29	18	26	20	18	14	312
	Pseudomonas aeruginosa	9	12	9	12	7	5	7	6	8	8	9	6	11	109
	Pseudomonas aeruginosa (MBL)	0	0	0	0	0	0	1	0	0	1	0	0	0	2
	Stenotrophomonas maltophila	0	0	4	0	1	1	2	2	4	7	4	0	1	26
	Klebsiella pneumoniae	6	8	5	2	4	2	4	9	7	14	6	8	13	88
	Klebsiella pneumoniae (ESBL)	11	8	3	3	2	4	1	10	7	7	4	5	2	67
	Klebsiella pneumoniae (NDM)	0	0	0	0	0	0	0	0	0	0	2	1	2	5
	Klebsiella pneumoniae (KPC)	0	4	0	0	0	0	0	0	0	0	0	0	0	4
	Klebsiella pneumoniae (OXA 48)	0	0	0	0	0	0	0	0	0	0	0	0	1	1
	Escherichia coli	1	3	2	0	3	3	4	6	4	9	7	11	5	58
	Escherichia coli (ESBL)	0	2	0	0	0	0	0	0	0	2	3	3	1	11
	Enterobacter cloacae	1	0	1	0	1	1	3	3	2	5	5	7	5	34
	Enterobacter cloacae (ESBL)	0	0	1	1	0	0	0	1	0	2	0	2	0	7
	Proteus mirabilis	0	1	0	0	0	2	2	2	1	3	3	3	4	21
	Proteus mirabilis (ESBL)	4	3	0	0	0	0	0	0	0	0	2	0	0	9
	Morganella morgani	0	0	0	0	0	0	1	1	1	1	2	0	2	8
	Serratia marcescens	0	0	0	0	0	0	1	1	0	2	2	0	2	8
Gram-positive cocci	Staphylococcus aureus	1	5	1	3	7	3	3	3	4	4	4	9	18	65
	Staphylococcus aureus (MRSA)	3	7	15	3	5	4	2	3	7	3	2	4	0	58
	Coagulase-Staphylococcus negative (CNS)	2	2	5	3	2	2	6	4	6	12	5	1	4	54
	Coagulase-negative Staphylococcus (MRCNS)	31	25	34	35	22	34	35	23	38	28	18	15	30	368
	Enterococcus faecalis	5	8	15	5	5	5	4	5	6	16	2	6	13	95
	Enterococcus faecalis (HLAR)	0	3	9	0	3	0	0	0	1	2	0	0	2	20
	Enterococcus faecium	1	2	9	5	1	2	1	0	4	3	0	2	7	37
	Enterococcus faecium (VRE)	0	1	0	1	0	0	1	1	0	1	2	3	1	11
	Enterococcus faecium (HLAR)	1	1	1	6	1	2	1	1	1	1	0	3	2	21
	Streptococcus pneumoniae	0	0	0	0	0	0	0	0	0	0	1	1	1	3
	Neisseria meningitidis	1	0	0	0	0	0	0	0	0	0	0	0	0	1
Fungi	Candida albicans	5	3	4	5	2	4	1	1	2	1	2	1	3	34
	Candida glabrata	0	1	1	0	0	0	0	0	0	0	1	0	1	4
	Candida krusei	0	0	0	0	0	1	0	0	0	0	0	0	0	1
	Candida tropicalis	0	0	0	0	0	0	1	0	0	0	0	0	0	1
	Candida parapsilosis	0	2	0	0	0	2	1	1	3	1	1	0	3	14
	Total	115	125	141	103	104	103	107	112	124	159	107	109	148	1,557

Resistance of Gram-negative pathogens to antimicrobial agents_

Antimicrobial agent	Pseudomonas aeruginosa
	2007 n = 9	2008 n = 12	2009 n = 9	2010 n = 12	2011 n = 7	2012 n = 5	2013 n = 7	2014 n = 6	2015 n = 8	2016 n = 8	2017 n = 9	2018 n = 6	2019 n = 11
	Ceftazidime	2	4	3	0	0	0	1	0	0	2	1	0	0
Cefepime	0	3	0	0	1	1	2	0	0	3	1	0	0
Piperacillin/tazobactam	1	1	5	0	0	1	1	0	1	4	1	0	0
Gentamycin	5	4	5	1	3	2	3	0	0	4	0	0	0
Ciprofloxacin	6	3	5	0	2	2	2	2	2	5	3	2	0
Imipenem	3	2	4	4	2	1	2	0	2	5	4	3	7
Meropenem	3	0	4	3	2	1	2	0	1	4	4	3	7
				Acinetobacter baumannii
	2007 n = 33	2008 n = 24	2009 n = 22	2010 n = 19	2011 n = 38	2012 n = 26	2013 n = 25	2014 n = 29	2015 n = 18	2016 n = 26	2017 n = 20	2018 n = 18	2019 n = 14
Gentamycin	30	22	7	11	29	24	22	25	16	18	13	15	8
Ciprofloxacin	32	24	21	19	34	25	23	29	18	25	20	18	14
Imipenem	11	6	10	11	31	23	21	28	17	25	19	17	10
Meropenem	6	6	8	11	31	23	21	28	17	25	19	17	10
Trimethoprim-sulfamethoxazole	20	18	16	19	36	24	15	27	16	25	20	17	10
Ampicillin/sulbactam	12	12	8	12	19	3	9	20	16	nd	nd	nd	nd
Colistin	–	–	–	–	–	–	–	–	0	0	0	0	0
				Stenotrophomonas maltophila
	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019
	n = 0	n = 0	n = 4	n = 0	n = 1	n =	1 n = 2	n = 2	n = 4	n = 7	n = 4	n = 0	n = 1
Trimethoprim-sulfamethoxazole	–	–	0	–	0	0	0	0	0	0	0	–	0
				ESBL-negative Enterobacterales
	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019
	n = 8	n = 12	n = 8	n = 2	n = 8	n =	9 n = 15	n = 22	n = 15	n = 34	n = 25	n = 29	n = 31
Ceftazidime	0	0	0	0	0	0	0	0	0	0	0	0	0
Cefepime	0	0	0	0	0	0	0	0	0	0	0	0	0
Ciprofloxacin	0	3	3	0	1	0	5	1	2	10	6	4	5
Gentamycin	0	2	0	0	0	0	0	0	0	2	0	2	5
Piperacillin/tazobactam	0	0	1	0	0	0	1	1	0	0	1	4	8
Trimethoprim-sulfamethoxazole	3	2	3	1	1	1	6	1	0	3	4	2	4
				ESBL-positive Enterobacterales
	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019
	n = 15	n = 13	n = 4	n = 4	n = 2	n =	4 n = 1	n = 11	n = 7	n = 11	n = 9	n = 10	n = 3
Amoxicillin/clavulanate	12	9	3	4	2	4	1	11	6	8	9	10	3
Gentamycin	10	9	3	4	2	4	1	8	7	7	6	8	2
Ciprofloxacin	13	11	4	4	2	4	1	11	7	11	9	10	3
Imipenem	4	3	0	0	0	0	0	0	0	0	2	0	0
Meropenem	0	0	0	0	0	0	0	0	0	0	0	0	0
Trimethoprim-sulfamethoxazole	13	9	2	3	1	3	1	9	5	11	9	8	3
			KPC-producing Klebsiella pneumoniae
	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019
	n = 0	n = 4	n = 0	n = 0	n = 0	n =	0 n = 0	n = 0	n = 0	n = 0	n = 0	n = 0	n = 0
Amikacin	–	0	–	–	–	–	–	–	–	–	–	–	–
Gentamicin	–	0	–	–	–	–	–	–	–	–	–	–	–
Tigecycline	–	2	–	–	–	–	–	–	–	–	–	–	–
Trimethoprim-sulfamethoxazole	–	4	–	–	–	–	–	–	–	–	–	–	–
Colistin	–	0	–	–	–	–	–	–	–	–	–	–	–
	NDM-producing Klebsiella pneumoniae
Antimicrobial agent	2007 n = 0	2008 n = 0	2009 n = 0	2010 n = 0	2011 n = 0	2012 n = 0	2013 n = 0	2014 n = 0	2015 n = 0	2016 n = 0	2017 n = 2	2018 n = 1	2019 n = 2
Amikacin	–	–	–	–	–	–	–	–	–	–	2	1	2
Gentamicin	–	–	–	–	–	–	–	–	–	–	1	1	1
Tigecycline	–	–	–	–	–	–	–	–	–	–	2	1	0
Trimethoprim-sulfamethoxazole	–	–	–	–	–	–	–	–	–	–	1	1	1
Colistin	–	–	–	–	–	–	–	–	–	–	0	0	0
	OXA48-producing Klebsiella pneumoniae
	2007 n = 0	2008 n = 0	2009 n = 0	2010 n = 0	2011 n = 0	2012 n = 0	2013 n = 0	2014 n = 0	2015 n = 0	2016 n = 0	2017 n = 0	2018 n = 0	2019 n = 1
Amikacin	–	–	–	–	–	–	–	–	–	–	–	–	0
Gentamicin	–	–	–	–	–	–	–	–	–	–	–	–	1
Tigecycline	–	–	–	–	–	–	–	–	–	–	–	–	1
Trimethoprim-sulfamethoxazole	–	–	–	–	–	–	–	–	–	–	–	–	1
Colistin	–	–	–	–	–	–	–	–	–	–	–	–	0

Bloodstream Infections in the Intensive Care Unit: a Single-Center Retrospective Bacteriological Analysis Between 2007 and 2019

Figures & Tables

Fig. 1

Fig. 2

Fig. 3

Descriptive statistics of the study population and their primary diagnoses according to ICD10_

The number of microbiological analyses, with their results, performed between 2007 and 2019_

The number of pathogens isolated from blood samples between 2007 and 2019_

Resistance of Gram-negative pathogens to antimicrobial agents_

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