Incidence and bacteriological profile of bloodstream infections among patients admitted to Jenin governmental hospital: a retrospective observational study

Bloodstream infections (BSIs) lead to serious complications, an increased length of hospital stay, and a higher mortality rate. This study aimed to determine the incidence of BSIs among patients admitted to Jenin Governmental Hospital and to study the demographic and clinical data of patients diagnosed with BSIs, as well as to determine their microbiological profiles and antibiotic resistance. The present study is a four-month retrospective observational one conducted from October 2022 to February 2023 across various wards of Jenin Governmental Hospital in the north of the West Bank of Palestine. A total of 1495 blood cultures from 1190 patients were included in the study. Data collected included demographic data, ward, previous chronic diseases, inflammatory markers, different signs and symptoms, antibiotics used, and infected patient outcomes in terms of mortality and length of hospital stay. The study showed that 152 (10.2%) positive blood cultures were detected among a total of 1495 blood culture tests included in the study. The incidence of BSIs among inpatients was 13.9 (95% CI: 11.65–16.15) infections per 1000 patient-days, while among outpatients it was 3.7 (95% CI: 0.7–6.7)infections per 1000 patient visits. Of the BSI cases, 61 (40.1%) were community-acquired, and 91 (59.9%) were hospital-acquired. Regarding the type of pathogen in the present study, 55.9% of positive results were Gram-negative and 43.4% were Gram-positive. The most common Gram-negative bacteria were Klebsiell a spp. (19.1% of all detected pathogens), E. coli (11.2%),and Pseudomonas spp. (9.2%). Among Gram-positive bacteria, Staphylococcus aureus (32.2% ) was predominantly isolated. The highest BSI rate occurred in patients aged 40–59 years (16.0%; 95% CI: 11.1–22.6%), which was significantly ( P < 0.001) higher than that of patients less than1 month old (5.1%; 95% CI: 3.3–7.9%). Significant associations were found between the development of BSIs and dialysis ( P < 0.001). Remarkably, chills were significantly associated with BSIs ( P = 0.047). Resistance rates were highest against erythromycin (70.0%; 95% CI: 57.3–80.5%), and co-trimoxazole (55.0%; 95% CI: 39.8–69.3%) among Gram-positive bacteria, and against amoxicillin-clavulanic acid combination (74.0%; 95% CI: 61.1–83.8%) and cefuroxime (62.0%; 95% CI: 47.6–74.9%) among Gram-negative bacteria. There must be development of an antibiotic stewardship program because of the high rate of detection of multidrug-resistant bacteria. BSIs were associated with increased mortality and prolonged hospital stay.