Healthcare-associated blood stream infections in hematological patients in Finland during the years 2006-2016.
OBJECTIVES
The aim was to identify the clinical characteristics, outcome, and antimicrobial susceptibility of healthcare-associated bloodstream infections (BSIs) in hematological patients.


METHODS
This retrospectively collected laboratory-based surveillance data include 3404 healthcare-associated BSIs in 2296 patients with a hematological malignancy in hospitals participating in the Finnish Hospital Infection Program from January 1, 2006, to December 31, 2016.


RESULTS
The most common underlying diseases were acute myelogenous leukemia (35%) and non-Hodgkin lymphoma (22%). Gram-positive organisms accounted for 60%-46% and gram-negative organisms for 24%-36% of BSIs in 2006-2016. The most common causative organism was coagulase-negative staphylococci (CoNS) (n = 731). The 7- and 28-day case fatality rates were 5.2% and 11.4%, respectively, and was highest in BSIs caused by Candida species (10.8% and 30.8%). The median age of patients increased from 59 years in 2006-2008 to 62 years in 2015-2016 (P < .01). Five percent of S aureus isolates were resistant to methicillin and five percent of Pseudomonas aeruginosa isolates were multidrug-resistant. Four percent of Klebsiella and seven percent of E coli isolates were resistant to ceftazidime.


CONCLUSIONS
The proportion of gram-positive bacteria decreased and gram-negative bacteria increased over time. The case fatality rate was low and the median age of patients increased during the study.
['Åttman|Emilia|E|', 'Syrjänen|Jaana|J|', 'Lyytikäinen|Outi|O|', 'Ollgren|Jukka|J|', 'Sinisalo|Marjatta|M|', 'Vuento|Risto|R|', 'Mattila|Erja|E|', 'Huttunen|Reetta|R|']
healthcare-associated hematological bacteremia incidence density resistance rate