OBJECTIVE: To describe survival following nosocomial bloodstream infections and quantify excess mortality associated with positive blood culture. STUDY DESIGN: Multicenter cohort study of premature infants. RESULTS: First blood culture was negative for 4648/5497 (78%) of the neonates--390/4648 (8%) died prior to discharge. Mortality prior to discharge was 19% in the 161 infants with Gram-negative rod (GNR) bacteremia, 8% in the 854 neonates with coagulase negative staphylococcus (CONS), 6% in the 169 infants infected with other Gram-positive bacteria (GP-o), and 26% in the 115 neonates with candidemia. The excess 7-day mortality was 0% for Gram-positive organisms and 83% for GNR bacteremia and candidemia. Using negative blood culture as referent, GNR [hazard ratio (HR)=2.61] and candidemia (HR=2.27) were associated with increased mortality; CONS (HR=1.08) and GP-o (HR=0.97) were not. CONCLUSIONS: Nosocomial GNR bacteremia and candidemia were associated with increased mortality but Gram-positive bacteremia was not.
OBJECTIVE: To describe survival following nosocomial bloodstream infections and quantify excess mortality associated with positive blood culture. STUDY DESIGN: Multicenter cohort study of premature infants. RESULTS: First blood culture was negative for 4648/5497 (78%) of the neonates--390/4648 (8%) died prior to discharge. Mortality prior to discharge was 19% in the 161 infants with Gram-negative rod (GNR) bacteremia, 8% in the 854 neonates with coagulase negative staphylococcus (CONS), 6% in the 169 infants infected with other Gram-positive bacteria (GP-o), and 26% in the 115 neonates with candidemia. The excess 7-day mortality was 0% for Gram-positive organisms and 83% for GNR bacteremia and candidemia. Using negative blood culture as referent, GNR [hazard ratio (HR)=2.61] and candidemia (HR=2.27) were associated with increased mortality; CONS (HR=1.08) and GP-o (HR=0.97) were not. CONCLUSIONS:Nosocomial GNR bacteremia and candidemia were associated with increased mortality but Gram-positive bacteremia was not.
Authors: K C Wade; D Wu; D A Kaufman; R M Ward; D K Benjamin; J E Sullivan; N Ramey; B Jayaraman; K Hoppu; P C Adamson; M R Gastonguay; J S Barrett Journal: Antimicrob Agents Chemother Date: 2008-09-22 Impact factor: 5.191
Authors: James L Wynn; Daniel K Benjamin; Daniel K Benjamin; Michael Cohen-Wolkowiez; Reese H Clark; P Brian Smith Journal: Early Hum Dev Date: 2011-09-15 Impact factor: 2.079
Authors: Michael Cohen-Wolkowiez; Cassandra Moran; Daniel K Benjamin; C Michael Cotten; Reese H Clark; Daniel K Benjamin; P Brian Smith Journal: Pediatr Infect Dis J Date: 2009-12 Impact factor: 2.129