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Multicenter surveillance of the epidemiology of gram-negative bacteremia in Japan.
J Infect Chemother. 2020 Jan 10 [Online ahead of print]JI

Abstract

This study investigated the epidemiology of adult patients with bacteremia caused by seven major gram-negative bacteria during a year at four university hospitals in Japan. Of the 438 cases included, Escherichia coli (247 patients) was the most frequently isolated pathogen, followed by Klebsiella species (89 patients), Enterobacter species (31 patients), Pseudomonas aeruginosa (29 patients), Bacteroides species (19 patients), Acinetobacter species (12 patients) and Stenotrophomonas maltophilia (11 patients). The overall, crude in-hospital mortality was 16.4%, ranging from 9.7% with Enterobacter species to 54.5% with S. maltophilia. Community- and hospital-acquired bacteremia accounted for 52.5% and 47.5%, respectively. Enterobacteriaceae were isolated from 93.0% of patients with community-acquired bacteremia, whereas non-fermenting bacteria were isolated from 21.6% of patients with hospital-acquired bacteremia. Of the 423 patients analyzed, 86.8% and 13.2% were monomicrobial and polymicrobial infections, respectively, and their in-hospital mortalities were 13.9% and 30.4%, respectively. Although carbapenem-resistant Enterobacteriaceae were not detected, extended-spectrum β-lactamase (ESBL) production was seen in 24.3% of E. coli and 6.7% of Klebsiella species, respectively. E. coli producing ESBL showed high resistance rates to fluoroquinolones (approximately 90%), in contrast to non-producing-E. coli (approximately 21%). The susceptibilities to carbapenems and fluoroquinolones were approximately 80% for P. aeruginosa, whereas all Acinetobacter species were susceptible to these antibiotics. Bacteroides species showed 100% susceptibility to piperacillin/tazobactam and carbapenems, but only 47.4% were susceptible to clindamycin. Further studies, as well as continued surveillance, are required to determine the appropriate therapeutic strategy for gram-negative bacteremia.

Authors+Show Affiliations

Department of Laboratory Medicine, Nagasaki University Hospital, Japan. Electronic address: k-kosai@nagasaki-u.ac.jp.Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.Hospital Infection Control Center, Oita University Hospital, Japan.Department of Infection Prevention and Control, Hyogo College of Medicine, Japan.Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.Hospital Infection Control Center, Oita University Hospital, Japan.Department of Infection Prevention and Control, Hyogo College of Medicine, Japan.Department of Laboratory Medicine, Nagasaki University Hospital, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31932213

Citation

Kosai, Kosuke, et al. "Multicenter Surveillance of the Epidemiology of Gram-negative Bacteremia in Japan." Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy, 2020.
Kosai K, Yamagishi Y, Hashinaga K, et al. Multicenter surveillance of the epidemiology of gram-negative bacteremia in Japan. J Infect Chemother. 2020.
Kosai, K., Yamagishi, Y., Hashinaga, K., Nakajima, K., Mikamo, H., Hiramatsu, K., Takesue, Y., & Yanagihara, K. (2020). Multicenter surveillance of the epidemiology of gram-negative bacteremia in Japan. Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy. https://doi.org/10.1016/j.jiac.2019.11.003
Kosai K, et al. Multicenter Surveillance of the Epidemiology of Gram-negative Bacteremia in Japan. J Infect Chemother. 2020 Jan 10; PubMed PMID: 31932213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multicenter surveillance of the epidemiology of gram-negative bacteremia in Japan. AU - Kosai,Kosuke, AU - Yamagishi,Yuka, AU - Hashinaga,Kazuhiko, AU - Nakajima,Kazuhiko, AU - Mikamo,Hiroshige, AU - Hiramatsu,Kazufumi, AU - Takesue,Yoshio, AU - Yanagihara,Katsunori, Y1 - 2020/01/10/ PY - 2019/07/25/received PY - 2019/10/15/revised PY - 2019/11/13/accepted PY - 2020/1/15/entrez KW - Blood stream infection KW - Drug resistance KW - Mortality KW - Polymicrobial infection JF - Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy JO - J. Infect. Chemother. N2 - This study investigated the epidemiology of adult patients with bacteremia caused by seven major gram-negative bacteria during a year at four university hospitals in Japan. Of the 438 cases included, Escherichia coli (247 patients) was the most frequently isolated pathogen, followed by Klebsiella species (89 patients), Enterobacter species (31 patients), Pseudomonas aeruginosa (29 patients), Bacteroides species (19 patients), Acinetobacter species (12 patients) and Stenotrophomonas maltophilia (11 patients). The overall, crude in-hospital mortality was 16.4%, ranging from 9.7% with Enterobacter species to 54.5% with S. maltophilia. Community- and hospital-acquired bacteremia accounted for 52.5% and 47.5%, respectively. Enterobacteriaceae were isolated from 93.0% of patients with community-acquired bacteremia, whereas non-fermenting bacteria were isolated from 21.6% of patients with hospital-acquired bacteremia. Of the 423 patients analyzed, 86.8% and 13.2% were monomicrobial and polymicrobial infections, respectively, and their in-hospital mortalities were 13.9% and 30.4%, respectively. Although carbapenem-resistant Enterobacteriaceae were not detected, extended-spectrum β-lactamase (ESBL) production was seen in 24.3% of E. coli and 6.7% of Klebsiella species, respectively. E. coli producing ESBL showed high resistance rates to fluoroquinolones (approximately 90%), in contrast to non-producing-E. coli (approximately 21%). The susceptibilities to carbapenems and fluoroquinolones were approximately 80% for P. aeruginosa, whereas all Acinetobacter species were susceptible to these antibiotics. Bacteroides species showed 100% susceptibility to piperacillin/tazobactam and carbapenems, but only 47.4% were susceptible to clindamycin. Further studies, as well as continued surveillance, are required to determine the appropriate therapeutic strategy for gram-negative bacteremia. SN - 1437-7780 UR - https://www.unboundmedicine.com/medline/citation/31932213/Multicenter_surveillance_of_the_epidemiology_of_gram-negative_bacteremia_in_Japan L2 - https://linkinghub.elsevier.com/retrieve/pii/S1341-321X(19)30344-7 DB - PRIME DP - Unbound Medicine ER -
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