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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MDPI AG
2025-01-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/13/1/183 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Olivia D. Conroy |
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| description | 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. |
| format | Article |
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| institution | Kabale University |
| issn | 2076-2607 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj-art-decbc941790b4cb9afb07e9c773501dd2025-01-24T13:42:57ZengMDPI AGMicroorganisms2076-26072025-01-0113118310.3390/microorganisms13010183Bloodstream Infections in Critical Care Units in England, April 2017 to March 2023: Results from the First Six Years of a National Surveillance ProgrammeOlivia D. Conroy0Andrea Mazzella1Hannah Choi2Jocelyn Elmes3Matt Wilson4Dimple Y. Chudasama5Sarah M. Gerver6Miroslava Mihalkova7Andrew Rhodes8A. Peter R. Wilson9Nicholas Brown10Jasmin Islam11Russell Hope12City of Wolverhampton Council, Wolverhampton WV1 1SH, UKUK Health Security Agency, London E14 4PU, UKTower Hamlets London Borough Council, London E1 1BJ, UKUK Health Security Agency, London E14 4PU, UKUK Health Security Agency, London E14 4PU, UKUK Health Security Agency, London E14 4PU, UKUK Health Security Agency, London E14 4PU, UKUK Health Security Agency, London E14 4PU, UKSt. George’s Hospital, London SW17 0QT, UKDepartment of Microbiology, University College London Hospitals, London NW1 2BU, UKCambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UKUK Health Security Agency, London E14 4PU, UKUK Health Security Agency, London E14 4PU, UKBackground: 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.https://www.mdpi.com/2076-2607/13/1/183bacteremiabloodstream infectionantibiotic resistancecritical carecentral venous catheterscase-fatality rate |
| spellingShingle | 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 Bloodstream Infections in Critical Care Units in England, April 2017 to March 2023: Results from the First Six Years of a National Surveillance Programme Microorganisms bacteremia bloodstream infection antibiotic resistance critical care central venous catheters case-fatality rate |
| title | Bloodstream Infections in Critical Care Units in England, April 2017 to March 2023: Results from the First Six Years of a National Surveillance Programme |
| title_full | Bloodstream Infections in Critical Care Units in England, April 2017 to March 2023: Results from the First Six Years of a National Surveillance Programme |
| title_fullStr | Bloodstream Infections in Critical Care Units in England, April 2017 to March 2023: Results from the First Six Years of a National Surveillance Programme |
| title_full_unstemmed | Bloodstream Infections in Critical Care Units in England, April 2017 to March 2023: Results from the First Six Years of a National Surveillance Programme |
| title_short | Bloodstream Infections in Critical Care Units in England, April 2017 to March 2023: Results from the First Six Years of a National Surveillance Programme |
| title_sort | bloodstream infections in critical care units in england april 2017 to march 2023 results from the first six years of a national surveillance programme |
| topic | bacteremia bloodstream infection antibiotic resistance critical care central venous catheters case-fatality rate |
| url | https://www.mdpi.com/2076-2607/13/1/183 |
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