Incidence, antimicrobial resistance and mortality of bloodstream infections among hospitalized patients in China: a retrospective observational multicenter cohort study from 2017 to 2021.

Background: accounts for high antimicrobial resistance and mortality rates of bloodstream infections (BSIs). We aim to investigate incidence, antimicrobial resistance and risk factors for mortality of . BSIs among inpatients.

Methods: A retrospective cohort study were conducted at two tertiary hospitals in 2017-2021. Medical and laboratory records of all inpatients diagnosed with . BSIs were reviewed. A generalized linear mixed model was used to identify risk factors for mortality.

Results: A total of 285 patients with . BSIs were identified. Incidence of . BSIs fluctuated between 2.37 and 3.51 per 100,000 patient-days over the study period. Out of 285 . isolates, 97 (34.04%) were carbapenem-resistant (CR) and 75 (26.32%) were multidrug-resistant (MDR). These isolates showed low resistance to aminoglycosides (9.51-11.62%), broad-spectrum cephalosporins (17.19-17.61%), fluoroquinolones (17.25-19.43%), and polymyxin B (1.69%). The crude 30-day mortality rate was 17.89% (51/285). Healthcare costs of patients with MDR/CR isolates were significantly higher than those of patients with non-MDR/CR isolates ( < 0.001/=0.002). Inappropriate definitive therapy [adjusted odds ratio (aOR) 4.47, 95% confidence interval (95% CI) 1.35-14.77; = 0.014], ICU stay (aOR 2.89, 95% CI: 1.26-6.63; = 0.012) and corticosteroids use (aOR 2.89, 95% CI: 1.31-6.41; = 0.009) were independently associated with 30-day mortality.

Conclusion: Incidence of . BSIs showed an upward trend during 2017-2020 but dropped in 2021. MDR/CR . BSIs are associated with higher healthcare costs. Awareness is required that patients with inappropriate definitive antimicrobial therapy, ICU stay and corticosteroids use are at higher risk of death from . BSIs.