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

Published online by Cambridge University Press:  28 June 2016

Niccolò Buetti ,
Jonas Marschall ,
Andrew Atkinson ,
Andreas Kronenberg  and
Swiss Centre for Antibiotic Resistance (ANRESIS)
Niccolò Buetti
Affiliation:
Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland
Jonas Marschall*
Affiliation:
Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland
Andrew Atkinson
Affiliation:
Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland
Andreas Kronenberg
Affiliation:
Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
*
Address correspondence to Jonas Marschall, MD, Freiburgstrasse 4, 3010 Bern, Switzerland (jonas.marschall@insel.ch).
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Abstract

OBJECTIVE

To characterize the epidemiology of bloodstream infections in Switzerland, comparing selected pathogens in community and university hospitals.

DESIGN

Observational, retrospective, multicenter laboratory surveillance study.

METHODS

Data on bloodstream infections from 2008 through 2014 were obtained from the Swiss infection surveillance system, which is part of the Swiss Centre for Antibiotic Resistance (ANRESIS). We compared pathogen prevalences across 26 acute care hospitals. A subanalysis for community-acquired and hospital-acquired bloodstream infections in community and university hospitals was performed.

RESULTS

A total of 42,802 bloodstream infection episodes were analyzed. The most common etiologies were Escherichia coli (28.3%), Staphylococcus 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 = .04). E. coli and S. aureus were more commonly reported in community than university hospitals (34.3% vs 22.7%, P<.001 and 13.9% vs 11.1%, P<.001, respectively). Fifty percent of episodes were community-acquired, with E. coli again being more common in community hospitals (41.0% vs 32.4%, P<.001). The proportion of E. coli in community-acquired bloodstream infections increased in community hospitals only. Community-acquired polymicrobial infections (9.9% vs 5.6%, P<.001) and community-acquired coagulase-negative staphylococci (6.7% vs 3.4%, P<0.001) were more prevalent in university hospitals.

CONCLUSIONS

The role of E. coli as predominant pathogen in bloodstream infections has become more pronounced. There are distinct patterns in community and university hospitals, potentially influencing empirical antibiotic treatment.

Infect Control Hosp Epidemiol 2016;37:1060–1067

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 9 , September 2016 , pp. 1060 - 1067
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

Members of ANRESIS are listed at the end of the text.

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