Epidemiological characteristics of bloodstream infection in patients with somatic diseases

Abstract

In 1999, at the conference of the European Working Group on Nosocomial Infections, the term "bloodstream infection" was proposed in the presence of clinical symptoms and microorganisms in the bloodstream. The first classification of bloodstream infection consisted of 3 categories: hospital, iatrogenic and out-of-hospital. Then theywere classified into 5 categories. At the same time, bloodstream infection that occurred during the first 48 hours after the patient's admission to the medical organization were divided into 4 groups (A–D). "Group C" included bacteremia associated with invasive procedures and was classified into 5 subgroups.

The number of episodes of IR. The number of episodes of bloodstream infection in the world is growing depending on the geographical location of the country (from 1995 to 2002 increased by 40%, by 2007 ― by 14.3%). Among the sources of infection, the role of the respiratory, hepatobiliary, gastrointestinal, urogenital and urinary tracts, the presence of intravascular devices and pneumonia. Bloodstream infection is characterized by frequent infestation of men, staphylococcal etiology, catheter-association, and the presence of comorbid diseases. Re-episodes of Gram-negative bloodstream infection are more likely to occur within 3 months. Until 2004, Staphylococcus aureus was the leading pathogen of bloodstream infection; after 2005, Escherichia coli dominated.

These two pathogens succeeded each other in different years. Currently, pathogens of bloodstream infection in patients with therapeutic profile are gram-positive cocci, including CNS, S. aureus, enterococci, fungi and anaerobes. Bloodstream infection is characterized by polymicrobiality (35.7%), including bacterial-fungal (22%).

Keywords

bloodstream infection / epidemiological review / classification / sources of infection / microorganisms

References

[1] Friedman ND, Kaye KS, Stout JE, et al. Health care-associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med. 2002;137(10):791–797. doi: 10.7326/0003-4819-137-10-200211190-00007

[2] Friedman N.D., Kaye K.S., Stout J.E., et al. Health care-associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections // Ann Intern Med. 2002. Vol. 137, N 10. Р. 791–797. doi: 10.7326/0003-4819-137-10-200211190-00007

[3] Siegman-Igra Y, Fourer B, Orni-Wasserlauf R, et al. Reappraisal of community-acquired bacteremia: a proposal of a new classification for the spectrum of acquisition of bacteremia. Clin Inf Dis. 2002;34(11):1431–1439. doi: 10.1086/339809

[4] Siegman-Igra Y., Fourer B., Orni-Wasserlauf R., et al. Reappraisal of community-acquired bacteremia: a proposal of a new classification for the spectrum of acquisition of bacteremia // Clin Inf Dis. 2002. Vol. 34, N 11. P. 1431–1439. doi: 10.1086/339809

[5] Kanoksil M, Jatapai A, Peacock SJ. Epidemiology, microbiology and mortality associated with community-acquired bacteremia in northeast Thailand: a multicenter surveillance study. Plos One. 2013;8(1):e54714. doi: 10.1371/journal.pone.0054714

[6] Kanoksil M., Jatapai A., Peacock S.J. Epidemiology, microbiology and mortality associated with community-acquired bacteremia in northeast Thailand: a multicenter surveillance study // Plos One. 2013. Vol. 8, N 1. P. e54714. doi: 10.1371/journal.pone.0054714

[7] Laupland KB, Kibsey PC, Gregson DB, et al. Population-based laboratory assessment of the burden of community-onset bloodstream infection in Victoria, Canada. Epidemiol Infect. 2013;141(1):174–180. doi: 10.1017/S0950268812000428

[8] Laupland K.B., Kibsey P.C., Gregson D.B., et al. Population-based laboratory assessment of the burden of community-onset bloodstream infection in Victoria, Canada // Epidemiol Infect. 2013. Vol. 141, N 1. P. 174–180. doi: 10.1017/S0950268812000428

[9] Skogberg K, Lyytikainen O, Ollgren J, et al. Population-based burden of bloodstream infections in Finland. Clin Microbiol Infect. 2012;18(6):E170–E176. doi: 10.1111/j.1469-0691.2012.03845.x

[10] Skogberg K., Lyytikainen O., Ollgren J., et al. Population-based burden of bloodstream infections in Finland // Clin Microbiol Infect. 2012. Vol. 18, N 6. P. E170–E176. doi: 10.1111/j.1469-0691.2012.03845.x

[11] Wilson J, Elgohari S, Livermore DM, et al. Trends among pathogens reported as causing bacteraemia in England, 2004–2008. Clin Microbiol Infect. 2011;17(3):451–458. doi: 10.1111/j.1469-0691.2010.03262.x

[12] Wilson J., Elgohari S., Livermore D.M., et al. Trends among pathogens reported as causing bacteraemia in England, 2004–2008 // Clin Microbiol Infect. 2011. Vol. 17, N 3. P. 451–458. doi: 10.1111/j.1469-0691.2010.03262.x

[13] Pien BC, Sundaram P, Raoof N, et al. The clinical and prognostic importance of positive blood cultures in adults. Am J Med. 2010;123(9):819–828. doi: 10.1016/j.amjmed.2010.03.021

[14] Pien B.C., Sundaram P., Raoof N., et al. The clinical and prognostic importance of positive blood cultures in adults // Am J Med. 2010. Vol. 123, N 9. P. 819–828. doi: 10.1016/j.amjmed.2010.03.021

[15] Mehl A, Asvold BO, Lydersen S, et al. Burden of bloodstream infection in an area of Mid-Norway 2002–2013: a prospective population-based observational study. BMC Infect Dis. 2017;17(1): 205–219. doi: 10.1186/s12879-017-2291-2

[16] Mehl A., Asvold B.O., Lydersen S., et al. Burden of bloodstream infection in an area of Mid-Norway 2002–2013: a prospective population-based observational study // BMC Infect Dis. 2017. Vol. 17, N 1. P. 205–219. doi: 10.1186/s12879-017-2291-2

[17] Akimkin BG, Tuteljan AB, Orlova OA, et al. Healthcare Associated Infections (HAIs). Newsletter for 2018. Moscow: Central Research Institute of Epidemiology of Rospotrebnadzor; 2019. 51 с. (In Russ).

[18] Акимкин В.Г., Тутельян А.В., Орлова О.А., и др. Инфекции, связанные с оказанием медицинской помощи (ИСМП). Информационный бюллетень за 2018 г. Москва, 2019. 51 с.

[19] Huson MA, Stolp SM, van der Poll T, et al. Community ― acquired bacterial bloodstream infections in HIV ― infected patients: a systematic review. Clin Inf Dis. 2014;58(1):79–92. doi: 10.1093/cid/cit596

[20] Huson M.A., Stolp S.M., van der Poll T., et al. Community ― acquired bacterial bloodstream infections in HIV ― infected patients: a systematic review // Clin Inf Dis. 2014. Vol. 58, N 1. P. 79–92. doi: 10.1093/cid/cit596

[21] Nedoseka VB, Goncharov AP. Prevention of the consequences of transient bacteremia. Clin Stomatol. 2002;(3):27–28. (In Russ).

[22] Недосека В.Б., Гончаров А.П. Профилактика последствий транзиторной бактериемии // Клиническая стоматология. 2002. № 3. С. 27–28.

[23] Son JS, Song JH, Ko KS, et al. Bloodstream infections and clinical significance of healthcare-associated bacteremia: a multicenter surveillance study in Korean hospitals. J Korean Med Sci. 2010;25(7):992–998. doi: 10.3346/jkms.2010.25.7.992

[24] Son J.S., Song JH., Ko K.S., et al. Bloodstream infections and clinical significance of healthcare-associated bacteremia: a multicenter surveillance study in Korean hospitals // J Korean Med Sci. 2010. Vol. 25, N 7. P. 992–998. doi: 10.3346/jkms.2010.25.7.992

[25] Mironov AY, Savickaya KI, Vorobyov AA. Microflora of purulent-septic diseases in patients in the Moscow region. J Microbiol Epidemiol Immunobiology. 2000;(5):11–15. (In Russ).

[26] Миронов А.Ю., Савицкая К.И., Воробьёв А.А. Микрофлора гнойно-септических заболеваний у больных в Московской области // Журнал микробиологии, эпидемиологии и иммунобиологии. 2000. № 5. С. 11–15.

[27] Chebotar IV, Lazareva AV, Masalov YK, et al. Acinetobacter: microbiological, pathogenetic and resistant properties. Bulletin RAMN. 2014;69(9-10):39–50. (In Russ). doi: 10.15690/vramn.v69i9-10.1130

[28] Чеботарь И.В., Лазарева А.В., Масалов Я.К., и др. Acinetobacter: микробиологические, патогенетические и резистентные свойства // Вестник РАМН. 2014. Т. 69, № 9-10. С. 39–50. doi: 10.15690/vramn.v69i9-10.1130

[29] Kargaltseva NM, Kocherovets VI, Mironov AY, et al. Markers of inflammation and bloodstream infection (literature review). Clin Laboratory Diagnostics. 2019;64(7):435–442. (In Russ). doi: 10.18821/0869-2084-2019-64-7-435-442

[30] Каргальцева Н.М., Кочеровец В.И., Миронов А.Ю., и др. Маркеры воспаления и инфекция кровотока (обзор литературы) // Клиническая лабораторная диагностика. 2019. Т. 64, № 7. С. 435–442. doi: 10.18821/0869-2084-2019-64-7-435-442

[31] Courjon J, Demonchy E, Degand N, et al. Patients with community-acquired bacteremia of unknown origin: clinical characteristics and usefulness of microbiological results for therapeutic issues: a single-center cohort study. Ann Clin Microbiol Antimicrob. 2017;16(1):40–47. doi: 10.1186/s12941-017-0214-0

[32] Courjon J., Demonchy E., Degand N., et al. Patients with community-acquired bacteremia of unknown origin: clinical characteristics and usefulness of microbiological results for therapeutic issues: a single-center cohort study // Ann Clin Microbiol Antimicrob. 2017. Vol. 16, N 1. P. 40–47. doi: 10.1186/s12941-017-0214-0

[33] Hoenigl M, Wagner J, Raggam RB, et al. Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria. Plos One. 2014;9(8):e104702. doi: 10.1371/journal.pone.0104702

[34] Hoenigl M., Wagner J., Raggam R.B., et al. Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria // Plos One. 2014. Vol. 9, N 8. P. e104702. doi: 10.1371/journal.pone.0104702

[35] Laupland KB, Church DL. Population-based epidemiology and microbiology of community-onset bloodstream infections. Clin Microbiol Rev. 2014;27(4):647–664. doi: 10.1128/CMR.00002-14

[36] Laupland K.B., Church D.L. Population-based epidemiology and microbiology of community-onset bloodstream infections // Clin Microbiolм Rev. 2014. Vol. 27, N 4. P. 647–664. doi: 10.1128/CMR.00002-14

[37] Al-Hasan MN, Eckel-Passow JE, Baddour LM. Recurrent gram-negative bloodstream infection a 10-years population ― based cohort study. J Infect. 2010;61(1):28–33. doi: 10.1016/j.jinf.2010.03.028

[38] Al-Hasan M.N., Eckel-Passow J.E., Baddour L.M. Recurrent gram-negative bloodstream infection a 10-years population ― based cohort study // J Infect. 2010. Vol. 61, N 1. P. 28–33. doi: 10.1016/j.jinf.2010.03.028

[39] Jensen US, Knudsen JD, Wehberg S, et al. Risk factors for recurrence and death after bacteraemia: apopulation-based study. Clin Microbiol Infect. 2011;17(8):1148–1154. doi: 10.1111/j.1469-0691.2011.03587.x

[40] Jensen U.S., Knudsen J.D., Wehberg S., et al. Risk factors for recurrence and death after bacteraemia: apopulation-based study // Clin Microbiol Infect. 2011. Vol. 17, N 8. P. 1148–1154. doi: 10.1111/j.1469-0691.2011.03587.x

[41] Diekema DJ, Hsueh PR, Mendes RE, et al. The microbiology of bloodstream infections: 20-year trends from the SENTRY antimicrobial surveillance program. Antimicrobial Agents Chemotherapy. 2019;63(7):1–10. doi: 10.1128/AAC.00355-19

[42] Diekema D.J., Hsueh P.R., Mendes R.E., et al. The microbiology of bloodstream infections: 20-year trends from the SENTRY antimicrobial surveillance program // Antimicrobial Agents and Chemotherapy. 2019. Vol. 63, N 7. P. 1–10. doi: 10.1128/AAC.00355-19

[43] Laupland KB, Lyytilcainen O, Sogaard M, et al. The changing epidemiology of Staphylococcus aureus bloodstream infection: a multinational population-based surveillance study. Clin Microbiol Infect. 2013;19(5):465–471. doi: 10.1111/j.1469-0691.2012.03903.x

[44] Laupland K.B., Lyytilcainen O., Sogaard M., et al. The changing epidemiology of Staphylococcus aureus bloodstream infection: a multinational population-based surveillance study // Clin Microbiol Infect. 2013. Vol. 19, N 5. P. 465–471. doi: 10.1111/j.1469-0691.2012.03903.x

[45] Marchaim D, Zaidenstein R, Lazarovitch T, et al. Epidemiology of bacteremia episodes in a single center: increase in Gram-negative isolates, antibiotics resistance, and patient age. Eur J Clin Microbiol Infect Dis. 2008;27(11):1045–1051. doi: 10.1007/s10096-008-0545-z

[46] Marchaim D., Zaidenstein R., Lazarovitch T., et al. Epidemiology of bacteremia episodes in a single center: increase in Gram-negative isolates, antibiotics resistance, and patient age // Eur J Clin Microbiol Infect Dis. 2008. Vol. 27, N 11. P. 1045–1051. doi: 10.1007/s10096-008-0545-z

[47] Vena A, Munoz P, Alcala L, et al. Are incidence and epidemiology of anaerobic bacteremia really changing? Eur J Clin Microbiol Infect Dis. 2015;34(8):1621–1629. doi: 10.1007/s10096-015-2397-7

[48] Vena A., Munoz P., Alcala L., et al. Are incidence and epidemiology of anaerobic bacteremia really changing? // Eur J Clin Microbiol Infect Dis. 2015. Vol. 34, N 8. P. 1621–1629. doi: 10.1007/s10096-015-2397-7

[49] Just E. Understanding risk stratification, comorbidities, and the future of healthcare. Health Catalyst. 2017;(25):1–8.

[50] Just E. Understanding risk stratification, comorbidities, and the future of healthcare // Health Catalyst. 2017. Vol. 25. P. 1–8.

[51] Dat VQ, Vu HN, The HN, et al. Bacterial bloodstream infections in a tertiary infectious diseases’ hospital in Northern Vietnam: aetiology, drug resistance, and treatment outcome. BMC Infect Dis. 2017;17(1):493–504. doi: 10.1186/s12879-017-2582-7

[52] Dat V.Q., Vu H.N., The H.N., et al. Bacterial bloodstream infections in a tertiary infectious diseases’ hospital in Northern Vietnam: aetiology, drug resistance, and treatment outcome // BMC Infect Dis. 2017. Vol. 17, N 1. P. 493–504. doi: 10.1186/s12879-017-2582-7

[53] Ombelet S, Ronat JB, Walsh T, et al. Clinical bacteriology in low-resource settings: today’s solutions. Lancet Infect Dis. 2018;18(8) e248–e258. doi: 10.1016/S1473-3099(18)30093-8

[54] Ombelet S., Ronat JB., Walsh T., et al. Clinical bacteriology in low-resource settings: today’s solutions // The Lancet Infect Dis. 2018. Vol. 18, N 8. P. e248–e258. doi: 10.1016/S1473-3099(18)30093-8

[55] Damgaard C, Magnussen K, Enevold C, et al. Viable bacteria associated with red blood cells and plasma in freshly drawn blood donations. Plos One. 2015;10(3):1–9. doi: 10.1371/journal.pone.0120826

[56] Damgaard C., Magnussen K., Enevold C., et al. Viable bacteria associated with red blood cells and plasma in freshly drawn blood donations // Plos One. 2015. Vol. 10, N 3. P. 1–9. doi: 10.1371/journal.pone.0120826

[57] Kargaltseva NM, Kocherovets VI, Mironov AY, et al. Method for obtaining blood culture in the diagnosis of bloodstream infection. Clin Laboratory Diagnostics. 2020;65(3):185–190. (In Russ). doi: 10.18821/0869-2084-2020-65-3-185-190

[58] Каргальцева Н.М., Кочеровец В.И., Миронов А.Ю., и др. Метод получения гемокультуры при диагностике инфекции кровотока // Клиническая лабораторная диагностика. 2020. Т. 65, № 3. С. 185–190. doi: 10.18821/0869-2084-2020-65-3-185-190

[59] Mironov AY, Pashkov EP. Non-spore-forming anaerobes and their role in human pathology: Moscow; 1990. 66 с. (In Russ).

[60] Миронов А.Ю., Пашков Е.П. Неспорообразующие анаэробы и их роль в патологии человека. Москва, 1990. 66 с.

[61] Vershinina MG, Kalugina EY, Maykovskaya LP, et al. Optimization of the algorithm for laboratory diagnosis of bloodstream infections. Problems Med Mycology. 2016;18(2):50. (In Russ).

[62] Вершинина М.Г., Калугина Е.Ю., Майковская Л.П., и др. Оптимизация алгоритма лабораторной диагностики инфекций кровотока // Проблемы медицинской микологии. 2016. Т. 18, № 2. С. 50.

[63] Lisovskaya SA, Khaldeeva EV, Glushko NI. The role of bacterial-fungal associations in the development of healthcare-associated infections. Practical Med. 2016;5:30–33. (In Russ).

[64] Лисовская С.А., Халдеева Е.В., Глушко Н.И. Роль бактериально-грибковых ассоциаций в развитии инфекций, связанных с оказанием медицинской помощи // Практическая медицина. 2016. № 5. С. 30–33.

[65] Leonov VV, Mironov AY. Biofilm formation of opportunistic microorganisms in blood plasma depending on the iron content. Clin Laborat Diagnostics. 2016;61(1):52–54. (In Russ).

[66] Леонов В.В., Миронов А.Ю. Биоплёнкообразование оппортунистических микроорганизмов в плазме крови в зависимости от содержания железа // Клиническая лабораторная диагностика. 2016. Т. 61, № 1. С. 52–54.

[67] Kargaltseva NM, Kocherovets VI, Ivanov AM. Polymicrobiality of blood cultures is a modern trend in the etiology of bloodstream infection. Practical Med. 2012;56(1):56–61. (In Russ).

[68] Каргальцева Н.М., Кочеровец В.И., Иванов А.М. Полимикробность гемокультур ― современная тенденция в этиологии инфекции кровотока // Практическая медицина. 2012. Т. 56, № 1. С. 56–61.

[69] Vorobyov AA, Bykov AS, Boichenko MN, et al. Medical microbiology, virology and immunology: a textbook for medical students. 3rd ed., revised. Moscow: Medical Information Agency; 2022. 704 р. (In Russ).

[70] Воробьев А.А., Быков А.С., Бойченко М.Н., и др. Медицинская микробиология, вирусология и иммунология. Учебник для студентов медицинских вузов. 3-е изд., испр. Москва: МИА, 2022. 704 с.

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