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Background: In light of the recently described shift in bloodstream infections towards Gram-negative bacteria, we wanted to elucidate the epidemiology of bloodstream infections in Switzerland, comparing selected pathogens in both community (CH) and university hospitals (UH). Methods: Data on bloodstream infections from 2008 to 2014 were obtained from the representative Swiss infection surveillance system ANRESIS. Using descriptive statistics we compared pathogen prevalence over time in all 26 participating acute care hospitals. We performed a subanalysis of community-acquired (CA) and hospital-acquired (HA) bloodstream infections in CH and UH. Results: We analyzed a total of 42’802 bloodstream infection episodes. The most common etiologies were E. coli (28.3%), S. aureus (12.4%) and polymicrobial bloodstream infections (11.4%). The proportion of E.coli increased from 27.5% in 2008 to 29.6% in 2014 (p=0.04). E. coli and S. aureus were more commonly reported in CH (34.3% vs 22.7%, p<0.001 and 13.9% vs 11.1%, p<0.001, respectively). Fifty percent (21’308) of episodes were CA, with E. coli again being more common in CHs (41.0% vs 32.4%, p<0.001). The proportion of E. coli in CA bloodstream infections even increased over time in CH. In contrast, CApolymicrobial infections (9.9% vs 5.6%, p<0.001) and CA-CoNS (6.7% vs 3.4%, p<0.001) were more prevalent in UH, and their frequency in UH was more pronounced in the HA subset of bloodstream infections. Conclusion: E. coli’s role as predominant pathogen in bloodstream infections in Switzerland has recently become more pronounced. There are distinct patterns in CHs and UHs, potentially influencing empiric antibiotic treatment.

National Bloodstream Infection Surveillance in Switzerland 2008–2014: Patterns and Trends Differ Between University and Community Hospitals