Bloodstream Infections in Critical Care Units in England, April 2017 to March 2023: Results from the First Six Years of a National Surveillance Programme

Bloodstream Infections in Critical Care Units in England, April 2017 to March 2023: Results from the First Six Years of a National Surveillance Programme

Background: Patients in critical care units (CCUs) are at an increased risk of bloodstream infections (BSIs), which can be associated with central vascular catheters (CVCs). This study describes BSIs, CVC-BSIs, organism distribution, percentage of antimicrobial resistant (AMR) organisms, and case fa...

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Main Authors: Olivia D. Conroy, Andrea Mazzella, Hannah Choi, Jocelyn Elmes, Matt Wilson, Dimple Y. Chudasama, Sarah M. Gerver, Miroslava Mihalkova, Andrew Rhodes, A. Peter R. Wilson, Nicholas Brown, Jasmin Islam, Russell Hope
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Microorganisms
Subjects:
bacteremia
bloodstream infection
antibiotic resistance
critical care
central venous catheters
case-fatality rate
Online Access:https://www.mdpi.com/2076-2607/13/1/183
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Summary:Background: Patients in critical care units (CCUs) are at an increased risk of bloodstream infections (BSIs), which can be associated with central vascular catheters (CVCs). This study describes BSIs, CVC-BSIs, organism distribution, percentage of antimicrobial resistant (AMR) organisms, and case fatality rates (CFRs) over the first six years of a voluntary national CCU surveillance programme in England. Methods: Surveillance data on BSIs, CVCs, and bed-days between 04/2017 and 03/2023 for adult CCUs were linked to mortality and AMR data, and crude rates were calculated. Results: The rates of CCU-BSIs and CCU-CVC-BSIs were stable for the first three years (3.6 and 1.7 per 1000 bed-days in 2019/20), before increasing by 75% and 94% in 2020/21, respectively, and returning to near pre-pandemic levels by 2022/23. Gram-negative bacteria accounted for 50.3% of all CCU-BSIs, followed by Gram-positive bacteria (39.6%) and <i>Candida</i> spp. (8.6%). <i>Klebsiella</i> spp. saw increases in percentage AMR, whereas other organisms saw declines or similar levels. The overall CFR was 30.2%. Conclusions: BSI incidence in CCUs remained stable across the study period, except for an increase in 2020/21 which reverted by 2022/23. These data provide a benchmark for CCUs and give insight into long-term AMR patterns where comparable national data are limited.
ISSN:2076-2607

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