OBJECTIVE: To examine the association between the source of infection, other factors and the 30-day case-fatality rate (CFR) in patients with community-acquired bacteremia. METHODS: We included in the study 1844 patients older than 15 years (median age 72 years) with a first episode of community-acquired bacteremia in the period 1992-97 from a population-based bacteremia database. Information on co-morbidity, antibiotic prescriptions and date of death was obtained from health registries through linkage with the patient's personal identification number. The outcome measure was the overall CFR. RESULTS: The mean CFR was 18% (20% in 1992-95, 15% in 1996-97). The commonest sources of infection were the urinary tract (29%) and the respiratory tract (20%); patients with an undetermined source accounted for 21% in 1992-95 and 13% in 1996-97. The most frequent bacteria were Escherichia coli (33%) and Streptococcus pneumoniae (22%). Thirty-two per cent of patients did not receive appropriate empirical antibiotic therapy. The following factors were associated with CFR: source of infection other than the urinary tract, first four years of the study, age >/=75 years, and presence of co-morbidity. An undetermined source showed the strongest association with CFR during the period 1996-97. CONCLUSIONS: As an undetermined source of infection was strongly associated with CFR, physicians should be aware of the significance of identifying and eliminating a source of infection, and more efforts should be directed at timely and appropriate empirical antibiotic therapy.
OBJECTIVE: To examine the association between the source of infection, other factors and the 30-day case-fatality rate (CFR) in patients with community-acquired bacteremia. METHODS: We included in the study 1844 patients older than 15 years (median age 72 years) with a first episode of community-acquired bacteremia in the period 1992-97 from a population-based bacteremia database. Information on co-morbidity, antibiotic prescriptions and date of death was obtained from health registries through linkage with the patient's personal identification number. The outcome measure was the overall CFR. RESULTS: The mean CFR was 18% (20% in 1992-95, 15% in 1996-97). The commonest sources of infection were the urinary tract (29%) and the respiratory tract (20%); patients with an undetermined source accounted for 21% in 1992-95 and 13% in 1996-97. The most frequent bacteria were Escherichia coli (33%) and Streptococcus pneumoniae (22%). Thirty-two per cent of patients did not receive appropriate empirical antibiotic therapy. The following factors were associated with CFR: source of infection other than the urinary tract, first four years of the study, age >/=75 years, and presence of co-morbidity. An undetermined source showed the strongest association with CFR during the period 1996-97. CONCLUSIONS: As an undetermined source of infection was strongly associated with CFR, physicians should be aware of the significance of identifying and eliminating a source of infection, and more efforts should be directed at timely and appropriate empirical antibiotic therapy.
Authors: C Hernandez; N Cobos-Trigueros; C Feher; L Morata; C De La Calle; F Marco; M Almela; A Soriano; J Mensa; A Del Rio; J A Martinez Journal: Eur J Clin Microbiol Infect Dis Date: 2014-06-08 Impact factor: 3.267
Authors: K O Gradel; H C Schønheyder; L Pedersen; R W Thomsen; M Nørgaard; H Nielsen Journal: Eur J Clin Microbiol Infect Dis Date: 2006-03 Impact factor: 3.267