1093. Bacteremia: Changing Microbiology Over Six Years
Session: Poster Abstract Session: Clinical Infectious Diseases: Bacteremia and Endocarditis
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Slide1.GIF (710.4 kB)
  • Background: Monitoring BC results may help in detecting emerging trends. We describe current trends in bacteremia and type of organism.

    Methods: Review of BC (1/1/2010-12/31/2015) from adults (≥18 y old) in a 772-bed teaching hospital in Detroit, Michigan. Positive BCs were considered to represent bacteremia if a known pathogen is isolated from one BC or a commensal organism in two or more BC. The rate of bacteremia (per/1000 discharges) and the type of organism were determined.Results:

    We reviewed 66641 BC, 7993 (12.0%) were positive, representing 3925 bacteremic episodes among 2953 patients. Patient age and the rate of bacteremia increased in 2012 and remained elevated (table). Aerobic gram-positive bacteria (GPO) decreased whereas aerobic gram-negative organisms (GNO) increased. GPO decrease was mainly in Staphylococcus aureus while group B Streptococcus rate increased. GNO increase was evident in Escherichia coli only. 

    Trends in Bacteremia over six years: rate and type of organisms

    Study year N (%)

    2010

    2011

    2012

    2013

    2014

    2015

    pa

    N of bacteremias (Rate)

    509 (15.4)

    466 (15.4)

    783 (22.5)

    704 (22.3)

    734 (20.2)

    729 (27.5)

    <0.001

    Patient age: mean ±SDb

    61.0 ±16.1

    60.7 ±16.4

    64.7 ±17.6

    62.7 ±18.2

    63.3 ±17.6

    62.3 ±16.7

    <0.001b

    Gram-Positive organisms

    265 (52.1)

    253 (54.9)

    397 (50.7)

    334 (47.4)

    352 (48.0)

    345 (47.3)

    0.008

    S. aureus

    149 (29.3)

    142 30.5

    204 26.1

    164 23.3

    193 26.3

    163 22.4

    0.02

    Streptococcus pneumoniea

    6 (1.2)

    2 (0.4)

    25 (3.2)

    22 (3.1)

    14 (1.9)

    18 2.5

    0.9

    Group A Streptococcus

    4 (0.8)

    2 (0.7)

    9 (0.3)

    11 (0.3)

    5 (0.1)

    9 (0.3)

    0.4

    Group B Streptococcus

    2 (0.4)

    7 (1.5)

    18 (2.3)

    7 (1.0)

    12 (0.6)

    19 (2.6)

    0.03

    Enterococci

    33 (6.5)

    30 (6.4)

    48 (6.1)

    59 (5.5)

    43 (5.9)

    67 (9.2)

    0.09

    Gram-negative organisms

    215 (42.4)

    192 (41.2)

    361 (46.1)

    358 (45.7)

    380 (51.8)

    344 (47.2)

    <0.001

    Eschreciae coli

    63 (12.3)

    65 (13.9)

    164 (20.9)

    160 (22.7)

    161 (21.9)

    156 (21.4)

    <0.001

    Candida spp.

    22 (4.3)

    31 (6.6)

    31 (4.0)

    26 (3.7)

    23 (3.1)

    37 (5.1)

    0.4

    Anaerobes

    36 (7.1)

    23 (4.9)

    44 (5.6)

    54 (7.7)

    40 (5.4)

    63 (8.6)

    0.1

    a Extended Mantel-Haenzel tets for linear trends; b: analysis of variance.

    Conclusion:

    E. coli and group B Streptococcus bacteremias are increasing, probably due to aging population or changing source of bacteremia; whereas S. aureuscontinues to decrease probably due to better adherence to infection prevention measures.

    Riad Khatib, MD1, Leonard B. Johnson, MD, FIDSA2, Mohamad Fakih, MD, MPH, FIDSA1, Kathleen Riederer, BS, MT1, Laurence Briski, MD3 and Vladimir Labalo, MD4, (1)Medicine, St. John Hospital & Medical Center, Grosse Pointe Woods, MI, (2)Internal Medicine, St. John & Medical Center, Detroit, MI, (3)St John Hospital and Medical Center, Grosse Pointe Woods, MI, (4)Infectious Diseases, St. John Hospital and Medical Center, Grosse Pointe Woods, MI

    Disclosures:

    R. Khatib, None

    L. B. Johnson, None

    M. Fakih, None

    K. Riederer, None

    L. Briski, None

    V. Labalo, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.