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Background <p>Bloodstream infections (BSI) represent a growing and significant issue due to their associated mortality, morbidity, and economic burden. This study aimed to assess the prevalence of BSI from 2013 to 2023, by type and onset, and to describe patients’ characteristics and identified microorganisms.</p> Methods <p>Data from the point prevalence survey on infections and antimicrobial use in Spanish hospitals were analysed. Logistic regression was conducted to identify temporal trends and associations between different factors and hospital-acquired BSI (HA-BSI). Stepwise backward selection with bootstrap resampling was applied for refinement and internal validation.</p> Results <p>From 2013 to 2023, a total of 578,780 patients were included and 12,968 patients had a BSI. The mean prevalence of BSI was 22.4‰ (HA-BSI: 11.1‰; community-acquired BSI (CA-BSI): 11.3‰). BSI prevalence rose from 18.0‰ in 2013 to 24.3‰ in 2023, corresponding to a significant 3.5% yearly increase in the odds of infection (OR 1.035, 95% CI 1.029–1.040). This upward trend was also observed for HA-BSI and CA-BSI, with significant increases in the odds of 1.1% (OR 1.011, 95% CI 1.004–1.019) and 5.7% (OR 1.057, 95% CI 1.049–1.065), respectively. The multivariate logistic regression model identified CVC use as the strongest factor associated with BSI with an overall aOR of 8.31 (95% CI 7.58–9.12).</p> <p>The most common microorganisms in HA-BSI were Gram-positive cocci (52.4%) while <i>Enterobacterales</i> were more prevalent in CA-BSI (47.5%). Antimicrobial resistance was significantly higher in HA-BSI for methicillin-resistant <i>Staphylococcus aureus</i>, vancomycin-resistant <i>Enterococcus faecalis</i>, third-generation cephalosporin-resistant <i>Escherichia coli</i>, third-generation cephalosporin-resistant and carbapenem-resistant <i>Klebsiella pneumoniae</i>, and <i>Pseudomonas aeruginosa</i>.</p> Conclusions <p>The prevalence of BSI in hospitalised patients in Spain is high and has been increasing over the past decade for both HA-BSI and CA-BSI, underscoring the need for continued efforts to reduce BSI rates.</p>

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Trends in the prevalence of bloodstream infections in Spanish hospitals (2013–2023)

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  • 发表日期：

    2026年2月11日

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  • Lina Marcela Parra,
  • Raquel Escuredo,
  • Mireia Cantero,
  • Marta Eva Gonzalez-Perez,
  • Manuel García de la Vega,
  • Ángel Asensio,
  • Luisa Abraira,
  • Emma Alarcón,
  • José Luis Alfonso,
  • Natividad Algado,
  • Carmen Almagro,
  • Jesús Alonso,
  • Alfonso Alonso,
  • Maria Begoña Álvarez,
  • Reyes Alvarez-Ossorio,
  • Juana Amadoz,
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  • Joaquín Angas,
  • Francisco Manuel Antolín,
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  • Lluis Armadans,
  • Pablo Asensio,
  • Amaya Bacaicoa,
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  • Patricia Bajo,
  • Lucia Barreiro,
  • Albert Bas,
  • Daniel Bautista,
  • Encarnación Benítez,
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  • José Ignacio Blanco,
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  • Rosa Maria Blázquez,
  • Cristina Blei,
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  • Maria Mar Burgoa,
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  • María Mar Jiménez Rodríguez,
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  • María Teresa Ledo Varela,
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  • Ana Lérida Urteaga,
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  • Ramón Limón Ramírez,
  • Ruth López Barrachina,
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  • Ana Isabel López Figueras,
  • Nieves López Fresneña,
  • Juan Carlos López Poma,
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  • Joaquín Lopez-Contreras Gonzalez,
  • Virginia Lorenzo García,
  • María del Rocío Lorenzo Ortega,
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  • Beatriz Marín González,
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  • Jose Domingo Martin Garcia,
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  • Ana Martinez Sibat,
  • María Dolores Martos Morillo,
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  • Carles Mayordomo I. Fernandez,
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  • Guillermo Mena Pinilla,
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  • María Dolores Menéndez Fraga,
  • Teresa Monserrat Blasco,
  • Gregorio Montes Salas,
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  • Sira María Morales Zumel,
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  • Alejandro Morcillo,
  • Luis Antonio Moreno Borraz,
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  • Mercedes Moreno Moreno,
  • Julio Muñoz Miguel,
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  • Juan Francisco Navarro Gracia,
  • Paloma Navas Gutiérrez,
  • Beatriz Nieto Pereda,
  • Blanca O.’donnell Cortés,
  • Salvador Oña Compán,
  • Guillermo Ordoñez León,
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  • María Teresa Ortega Maján,
  • Rafael Manuel Ortí Lucas,
  • Vladimir Ospino Arias,
  • Beatriz Pacho Martin,
  • Cristina Paniagua Alcaraz,
  • Domingo Panizo Rivas,
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  • María Soledad Paris Perez,
  • Lina Marcela Parra Ramírez,
  • Nuria Pascual Aguirre,
  • Salvador Pastor Eixarch,
  • María Isabel Pena Yáñez,
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  • Raúl Perea Rafael,
  • María José Pereira Rodriguez,
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  • Shirley Beatriz Pérez Romero,
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  • Virginia Pomar,
  • Manuela Teresa Prieto Uceda,
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  • Antonio Quiroga Fernández,
  • Cecilia Ramirez Santillan,
  • Itziar Ramos-Argüelles,
  • Josep Rebull Fatsini,
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  • Silvia Soler,
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  • José Manuel Suárez,
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  • Jorge Taboada,
  • Rocío Taboada,
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  • María Antonia Torres,
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  • Jaime Turégano,
  • Mª Carmen Ubago,
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  • Raquel Valencia,
  • Carmen Valero,
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摘要

Background

Bloodstream infections (BSI) represent a growing and significant issue due to their associated mortality, morbidity, and economic burden. This study aimed to assess the prevalence of BSI from 2013 to 2023, by type and onset, and to describe patients’ characteristics and identified microorganisms.

Methods

Data from the point prevalence survey on infections and antimicrobial use in Spanish hospitals were analysed. Logistic regression was conducted to identify temporal trends and associations between different factors and hospital-acquired BSI (HA-BSI). Stepwise backward selection with bootstrap resampling was applied for refinement and internal validation.

Results

From 2013 to 2023, a total of 578,780 patients were included and 12,968 patients had a BSI. The mean prevalence of BSI was 22.4‰ (HA-BSI: 11.1‰; community-acquired BSI (CA-BSI): 11.3‰). BSI prevalence rose from 18.0‰ in 2013 to 24.3‰ in 2023, corresponding to a significant 3.5% yearly increase in the odds of infection (OR 1.035, 95% CI 1.029–1.040). This upward trend was also observed for HA-BSI and CA-BSI, with significant increases in the odds of 1.1% (OR 1.011, 95% CI 1.004–1.019) and 5.7% (OR 1.057, 95% CI 1.049–1.065), respectively. The multivariate logistic regression model identified CVC use as the strongest factor associated with BSI with an overall aOR of 8.31 (95% CI 7.58–9.12).

The most common microorganisms in HA-BSI were Gram-positive cocci (52.4%) while Enterobacterales were more prevalent in CA-BSI (47.5%). Antimicrobial resistance was significantly higher in HA-BSI for methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecalis, third-generation cephalosporin-resistant Escherichia coli, third-generation cephalosporin-resistant and carbapenem-resistant Klebsiella pneumoniae, and Pseudomonas aeruginosa.

Conclusions

The prevalence of BSI in hospitalised patients in Spain is high and has been increasing over the past decade for both HA-BSI and CA-BSI, underscoring the need for continued efforts to reduce BSI rates.