Table 4.
Characteristics of the pathogens in the initial blood culture in EUROBACT-2 and comparison with EUROBACT-1 and EPIC III studies
| Pathogens | EUROBACT-2 n = 2927 (%) |
EUROBACT-1 (n = 1317)* |
EPIC III BSI (n = 1239)** |
|---|---|---|---|
| Gram-negative bacteria | 1726 (59) | 759 (57.6) | 515 (44.6) |
| Klebsiella spp. | 482 (27.9) | 156 (20.1) | 144 (28) |
| Carbapenem resistant | 182 (37.8) | 59 (37.8) | 86 (59.7) |
| DTR* | 133 (27.6) | . | . |
| PDR* | 11 (2.3) | 3 (1.9) | . |
| Escherichia coli | 272 (15.8) | 98(12.9) | 116 (22.5) |
| Carbapenem resistant | 20 (7.4) | 1(1) | 32 (27.6) |
| DTR* | 9 (3.3) | . | . |
| PDR* | 0 (0) | 0(0) | . |
| Enterobacter spp. | 141 (8.2) | 88 (11.6) | . |
| Carbapenem resistant | 31 (22) | 5 (5.7) | . |
| DTR* | 8 (5.7) | . | . |
| PDR* | 0 (0) | 0(0) | . |
| Pseudomonas spp. | 247 (14.3) | 150 (19.7) | 67 (13) |
| Carbapenem resistant | 82 (33.2) | 56 (37.3) | 10 (14.9) |
| DTR* | 25 (10.1) | . | . |
| PDR* | 4 (1.6) | 0(0) | . |
| Acinetobacter spp. | 350 (20.3) | 160 (21.1) | 68 (13.2) |
| Carbapenem resistant | 296 (84.6) | 110 (68.7) | 53 (77.9) |
| DTR* | 176 (50.3) | . | . |
| PDR* | 8 (2.3) | 1 (0.6) | . |
| Other Gram-negative bacteria | 234 (13.6) | 107 (14.1) | 177 (34.4) |
| Carbapenem resistant | 24 (12.5) | . | . |
| Gram-positive bacteria | 910 (31.1) | 440 (33.4) | 494 (42.7) |
| Enterococcus spp. | 314 (34.5) | 144 (32.7) | 58 (11.7) |
| Enterococcus faecium | 156 (49.7) | 70 (48.6) | . |
| VRE | 37 (23.7) | 16 (22.9) | . |
| Coagulase-negative Staphylococcus | 273 (30) | 141(32) | 182 (36.8) |
| MRSE | 200 (73.3) | . | 73 (40.1) |
| Staphylococcus aureus | 251 (27.6) | 119 (27) | 180 (36.4) |
| MRSA | 93 (37.1) | 57 (47.9) | 54 (30) |
| Other Gram-positive bacteria | 72 (7.9) | 36 (8.2) | 40 (8.1) |
| Strict anaerobe bacteria | 61 (2.1) | 20 (1.5) | 19 (1.6) |
| Bacteroides | 29 (47.5) | . | . |
| Other anaerobes | 32 (52.5) | . | . |
| Fungi | 230 (7.9) | 98 (7.4) | 126 (10.9) |
| Candida albicans | 91 (39.6) | 56 (57.1) | 71 (56.3) |
| Candida non-albicans spp. | 133 (57.8) | 39 (39.8) | 53 (42.1) |
| Other fungi | 6 (2.6) | 4 (3.2) |
Percentages shown for the relevant pathogen or category. *denotes unavailable or not comparable data. MRSA and MRSE denotes the % of Staphylococcus aureus and Coagulase negative Staphylococcus resistant to methicillin, VRE the % of enterococcus faecium resistant to vancomycin. Carbapenem resistant is defined as at least one carbapenem has been tested and the isolate is resistant to all the carbapenems that have been tested. DTR: Difficult to treat resistance. PDR: Pan-drug resistant (resistant to all tested antibiotics). DTR status is determined on Enterobacteriaceae, Pseudomonas and Acinetobacter species and requires require antibiogram results for ≥ 1 carbapenem, ≥ 1 extended-spectrum cephalosporin, and ≥ 1 fluoroquinolone. Candida unknown species have been classified in non-albicans. All PDR pathogens are DTR, and all DTR are carbapenem-R, thus the count and proportion of DTR and carbapenem-R micro-organisms includes that of the more resistant categories. EUROBACT-1 reported susceptibilities on monomicrobial infections. EPIC III reported the pathogens from 1154 bacterial or fungal bloodstream infections, not restricted to hospital-acquired infections. Sum of percentages exceeds 100 because patients may have had more than 1 infection