{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:36:28Z","timestamp":1790328988108,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T00:00:00Z","timestamp":1621468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Bloodstream infection (BSI) is one of the most common serious bacterial infections worldwide and also a major contributor to in-hospital mortality. Determining the predictors of mortality is crucial for prevention and improving clinical prognosis in patients with nosocomial BSI.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A nationwide prospective cohort study was conducted from 2007 until 2016 in 16 teaching hospitals across China. Microbiological results, clinical information, and patient outcomes were collected to investigate the pathogenic spectrum and mortality rate in patients with BSI and identify outcome predictors using multivariate regression, prediction model, and Kaplan\u2013Meier analysis.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> No significant change was observed in the causative pathogen distribution during the 10-year period and the overall in-hospital mortality was 12.83% (480\/3,741). An increased trend was found in the mortality of patients infected with <jats:italic>Pseudomonas aeruginosa<\/jats:italic> or <jats:italic>Acinetobacter baumannii<\/jats:italic>, while a decreased mortality rate was noted in <jats:italic>Staphylococcus aureus<\/jats:italic>-related BSI. In multivariable-adjusted models, higher mortality rate was significantly associated with older age, cancer, sepsis diagnosis, ICU admission, and prolonged hospital stay prior to BSI onset, which were also determined using machine learning-based predictive model achieved by random forest algorithm with a satisfactory performance in outcome prediction.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Our study described the clinical and microbiological characteristics and mortality predictive factors in patients with BSI. These informative predictors would inform clinical practice to adopt effective therapeutic strategies to improve patient outcomes.<\/jats:p>","DOI":"10.3389\/fmed.2021.629671","type":"journal-article","created":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T05:32:31Z","timestamp":1621488751000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["Clinical Profile, Prognostic Factors, and Outcome Prediction in Hospitalized Patients With Bloodstream Infection: Results From a 10-Year Prospective Multicenter Study"],"prefix":"10.3389","volume":"8","author":[{"given":"Longyang","family":"Jin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunjiang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruobing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.cmi.2019.10.031","article-title":"Burden of bacterial bloodstream infection-a brief update on epidemiology and significance of multidrug-resistant pathogens","volume":"26","author":"Kern","year":"2020","journal-title":"Clin Microbiol Infect."},{"key":"B2","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1111\/1469-0691.12195","article-title":"Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe","volume":"19","author":"Goto","year":"2013","journal-title":"Clin Microbiol Infect."},{"key":"B3","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1111\/1469-0691.12144","article-title":"Incidence of bloodstream infection: a review of population-based studies","volume":"19","author":"Laupland","year":"2013","journal-title":"Clin Microbiol Infect."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e00355","DOI":"10.1128\/AAC.00355-19","article-title":"The microbiology of bloodstream infection: 20-year trends from the sentry antimicrobial surveillance program","volume":"63","author":"Diekema","year":"2019","journal-title":"Antimicrob Agents Chemother."},{"key":"B5","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/S0140-6736(18)30696-2","article-title":"Sepsis and septic shock","volume":"392","author":"Cecconi","year":"2018","journal-title":"Lancet."},{"key":"B6","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1007\/s00134-020-05950-6","article-title":"Bloodstream infections in critically ill patients: an expert statement","volume":"46","author":"Timsit","year":"2020","journal-title":"Intensive Care Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/j.chest.2017.02.008","article-title":"A 10-year review of total hospital-onset ICU bloodstream infections at an academic medical center","volume":"151","author":"Civitarese","year":"2017","journal-title":"Chest."},{"key":"B8","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1093\/jac\/dkaa397","article-title":"Predictors of mortality and clinical characteristics among carbapenem-resistant or carbapenemase-producing Enterobacteriaceae bloodstream infections in Spanish children","volume":"76","author":"Ara-Montojo","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"B9","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1080\/20469047.2018.1529459","article-title":"Predictors of mortality in children with nosocomial bloodstream infection","volume":"39","author":"Murni","year":"2019","journal-title":"Paediatr Int Child Health."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e1003336","DOI":"10.1371\/journal.pmed.1003336","article-title":"Antibiotic prescribing for lower UTI in elderly patients in primary care and risk of bloodstream infection: a cohort study using electronic health records in England","volume":"17","author":"Shallcross","year":"2020","journal-title":"PLoS Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.ijid.2018.03.022","article-title":"Bloodstream infections in cancer patients. 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