English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  Monitoring pathogens of bloodstream infections (BSI) and their antibiotic susceptibility is important to guide empiric antibiotic treatment strategies and prevention programs.  This study assessed the epidemiology of BSI and antibiotic resistance patterns at the German Federal State of Thuringia longitudinally.    Methods  A surveillance network consisting of 26 hospitals was established to monitor BSIs from 01/2015 to 12/2019. All blood culture results, without restriction of age of patients, of the participating hospitals were reported by the respective microbiological laboratory. A single detection of obligate pathogens and a repeated detection of coagulase-negative staphylococci,  Bacillus  spp.,  Corynebacterium  spp.,  Micrococcus  spp. and  Propionibacterium  spp., within 96 h were regarded as a relevant positive blood culture. If one of the aforementioned non-obligate pathogens has been detected only once within 96 h, contamination has been assumed. Logistic regression models were applied to analyse the relationship between resistance, year of BSI and hospital size. Generalized estimating equations were used to address potential clustering.    Results  A total of 343,284 blood cultures (BC) of 82,527 patients were recorded. Overall, 2.8% (n = 9571) of all BCs were classified as contaminated. At least one relevant pathogen was identified in 13.2% (n = 45,346) of BCs.  Escherichia coli  (25.4%) was the most commonly detected pathogen, followed by  Staphylococcus aureus  (15.2%),  Staphylococcus epidermidis  (8.1%) and  Klebsiella pneumoniae  (4.6%). In  S. aureus,  we observed a decline of methicillin resistance (MRSA) from 10.4% in 2015 to 2.5% in 2019 ( p  < 0.001). The rate of vancomycin resistance in  Enterococcus faecium  (VRE) has increased from 16.7% in 2015 to 26.9% in 2019 ( p  < 0.001), with a peak in 2018 (42.5%). In addition, we observed an increase of Cefotaxime (3GC) resistance in  E. coli  from 10.7% in 2015 to 14.5% in 2019 ( p  = 0.007) whereas 3GC resistance in  K. pneumoniae  was stable (2015: 9.9%; 2019: 7.4%,  p  = 0.35). Carbapenem resistance was less than 1% for both pathogens. These patterns were robustly observed across sensitivity analyses.    Conclusions  We observed evidence for a decline in MRSA, an increase in VRE and a very low rate of carbapenem resistance in gram-negative bacteria. 3GC resistance in  E. coli  increased constantly over time.    Supplementary Information  The online version contains supplementary material available at 10.1186/s13756-021-00997-6.

antimicrobial resistance and infection control

The epidemiology of bloodstream infections and antimicrobial susceptibility patterns in Thuringia, Germany: a five-year prospective, state-wide surveillance study (AlertsNet)