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The Microbiology of Bloodstream Infection: 20-Year Trends from the SENTRY Antimicrobial Surveillance Program
Journal article   Open access   Peer reviewed

The Microbiology of Bloodstream Infection: 20-Year Trends from the SENTRY Antimicrobial Surveillance Program

Daniel J Diekema, Po-Ren Hsueh, Rodrigo E Mendes, Michael A Pfaller, Kenneth V Rolston, Helio S Sader and Ronald N Jones
Antimicrobial agents and chemotherapy, Vol.63(7)
07/2019
DOI: 10.1128/aac.00355-19
PMCID: PMC6591610
PMID: 31010862
url
https://doi.org/10.1128/aac.00355-19View
Published (Version of record) Open Access

Abstract

Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory. Clinical data and isolates from 264,901 BSI episodes were collected. The most common pathogen overall was (20.7%), followed by (20.5%), (7.7%), (5.3%), and (5.2%). was the most frequently isolated pathogen overall in the 1997-to-2004 period, but was the most common after 2005. Pathogen frequency varied by geographic region, hospital-onset or community-onset status, and patient age. The prevalence of isolates resistant to oxacillin (ORSA) increased until 2005 to 2008 and then declined among hospital-onset and community-acquired BSI in all regions. The prevalence of vancomycin-resistant enterococci (VRE) was stable after 2012 (16.4% overall). Daptomycin resistance among and enterococci (DRE) remained rare (<0.1%). In contrast, the prevalence of multidrug-resistant (MDR) increased from 6.2% in 1997 to 2000 to 15.8% in 2013 to 2016. MDR rates were highest among nonfermentative Gram-negative bacilli (GNB), and colistin was the only agent with predictable activity against complex (97% susceptible). In conclusion, and were the predominant causes of BSI worldwide during this 20-year surveillance period. Important resistant phenotypes among Gram-positive pathogens (MRSA, VRE, or DRE) were stable or declining, whereas the prevalence of MDR-GNB increased continuously during the monitored period. MDR-GNB represent the greatest therapeutic challenge among common bacterial BSI pathogens.
 Klebsiella pneumoniae - isolation & purification Pseudomonas aeruginosa - isolation & purification Enterococcus faecalis - drug effects Klebsiella pneumoniae - drug effects Community-Acquired Infections - epidemiology Humans Bacteremia - microbiology Microbial Sensitivity Tests Klebsiella Infections - epidemiology Gram-Positive Bacterial Infections - microbiology Acinetobacter baumannii - isolation & purification Staphylococcal Infections - microbiology Drug Resistance, Bacterial - drug effects Acinetobacter Infections - microbiology Latin America - epidemiology Staphylococcus aureus - isolation & purification Europe - epidemiology Klebsiella Infections - microbiology Pseudomonas aeruginosa - drug effects Pseudomonas Infections - microbiology Gram-Positive Bacterial Infections - epidemiology Enterococcus faecalis - isolation & purification Staphylococcal Infections - epidemiology Pseudomonas Infections - epidemiology Acinetobacter Infections - epidemiology Bacteremia - epidemiology Anti-Bacterial Agents - pharmacology Acinetobacter baumannii - drug effects Staphylococcus aureus - drug effects Community-Acquired Infections - microbiology

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