The incidence of bloodstream infections from 8 types of bacteria under surveillance in patients at Ban Mi Hospital, Lopburi Province.

Abstract

      This retrospective study aimed to investigate the incidence of bloodstream infections among patients admitted to Banmi Hospital, Lopburi Province, as well as to assess the sources of infection, trends in antimicrobial resistance, and the impact of bloodstream infections on mortality. In addition, the study examined the association between infections in other organ systems and their progression to bloodstream infections. This study focused on bloodstream infections caused by eight surveillance bacteria in patients at Banmi Hospital, Lopburi Province, from January 2023 to December 2024.

      A total of 8,397 blood culture specimens were submitted from 3,463 patients. The incidence of bloodstream infections was 11% in 2023 and increased to 12% in 2024. The most frequently isolated pathogen in 2023 was Escherichia coli (51.9%), followed by Klebsiella pneumoniae (15.3%) and Staphylococcus aureus (10.7%). In 2024, S. aureus became the second most common pathogen (15.6%), followed by K. pneumoniae (12.1%). More than 80% of infections in both years originated from community-acquired sources, with no statistically significant difference between years (p > 0.05). Analysis of antimicrobial resistance trends revealed that Acinetobacter baumannii showed increasing resistance to carbapenems (from 54% to 86%) and aminoglycosides (from 54% to 71%). In contrast, K. pneumoniae and S. aureus exhibited decreasing resistance trends. E. coli maintained high resistance to co-trimoxazole, rising from 52% to 55%. The number of deaths from bloodstream infections was identical across both years (30 deaths), with no statistically significant difference (p > 0.05). However, the mortality proportion slightly declined from 22.9% to 21.3%. Patients with hospital-acquired infections had significantly higher mortality rates compared with those with community-acquired infections (p < 0.05). When classified by pathogen, Pseudomonas aeruginosa had the highest mortality rate at 75%, followed by A. baumannii at 50%, whereas Streptococcus pneumoniae was associated with no deaths. Regarding antibiotic utilization, third-generation cephalosporins had the highest Defined Daily Dose (DDD) throughout the study period, followed by methicillin and carbapenems, which corresponded with the distribution of pathogens identified in the hospital.