Author:
Alwazzeh Marwan Jabr,Alnimr Amani,Al Nassri Samia A.,Alwarthan Sara M.,Alhajri Mashael,AlShehail Bashayer M.,Almubarak Mahdi,Alghamdi Nada S.,Wali Haytham A.
Abstract
Abstract
Background
Despite tremendous efforts to prevent central line-associated bloodstream infections, they still remain life-threatening complications among hospitalized patients with significant morbidity and mortality worldwide. The emerging antibiotic-resistant bacteria and other risk factors, including patient comorbidities, complicate patient management.
Methods
A single-center retrospective observational study was conducted at King Fahad Hospital of the University, Eastern Province, Saudi Arabia. Hospitalized patients with confirmed central line-associated bloodstream infections between January 2015 and December 2020 were included. The primary objectives were to investigate the trends in antibiotic susceptibility patterns of the causative agents, coexisting comorbid conditions, and other risk factors associated with mortality.
Results
A total of 214 patients with confirmed central line-associated bloodstream infections were included (CLABSI). The overall 30-day mortality rate was 33.6%. The infection rates per 1000 central line days for medical, surgical, and pediatric intensive care units were 4.97, 2.99, and 4.56 per 1000 CL days, respectively. The overall microbiological trends showed a predominance of Gram-negative agents, a steady increase of fungal CLABSI up to 24.0% in 2020, and a high prevalence of multidrug resistance up to 47% of bacterial CLABSI. In addition, the study indicates a significant negative surviving correlation with diabetes mellitus, cardiovascular disease, lung disease, chronic kidney disease, and the presence of ≥ 3 comorbidities (P < 0.05).
Conclusion
The microbiological trends of the study population demonstrated a steady increase of CLABSI caused by Candida spp. with a predominance of Gram-negative pathogens. Stratifying the patients according to relevant mortality risk factors, including patient comorbidities, will help reduce CLABSI rates and improve patient outcomes.
Publisher
Springer Science and Business Media LLC
Subject
Pharmacology (medical),Infectious Diseases,Microbiology (medical),Public Health, Environmental and Occupational Health
Reference45 articles.
1. Bharadwaj R, Bal A, Kapila K, Mave V, Gupta A. Blood stream Infections. BioMed Res Int. 2014;2014:515273.
2. Rosenthal VD, Al-Abdely HM, El-Kholy AA, AlKhawaja SAA, Leblebicioglu H, Mehta Y, et al. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010–2015: device-associated module. Am J Infect Control. 2016;44(1):1495–504.
3. Balkhy HH, El-Saed A, Al-Abri SS, Alsalman J, Alansari H, Al Maskari Z et al. Rates of central line-associated bloodstream infection in tertiary care hospitals in 3 Arabian gulf countries: 6-year surveillance study. Am J Infect Control. 2017 1;45(5):e49–51.
4. Gaid E, Assiri A, McNabb S, Banjar W. Device-associated nosocomial Infection in general hospitals, Kingdom of Saudi Arabia, 2013–2016. J Epidemiol Glob Health. 2018;7(Suppl 1Suppl 1):35–40.
5. Al-Tawfiq JA, Amalraj A, Memish ZA. Reduction and surveillance of device-associated Infections in adult intensive care units at a Saudi Arabian hospital, 2004–2011. Int J Infect Dis IJID off Publ Int Soc Infect Dis. 2013;17(12):e1207–1211.