OBJECTIVE: To analyze the epidemiology and factors influencing mortality of ICU-acquired bacteremia. DESIGN: Prospective clinical study. SETTING: A medical-surgical ICU in an university hospital. PATIENTS: We recorded variables from 111 consecutive ICU-acquired episodes for a 3-year period. RESULTS: The attack rate was 1.9 episodes per 100 patient-days. The commonest isolates were coagulase-negative staphylococci, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. Intravascular catheters were the most frequent source of infection. Overall mortality was 31.5%, and 65.7% of all deaths were directly attributable to infection. Bacteremia from intra-abdominal, lower respiratory tract or unknown origin were associated with a poor prognosis. A logistic regression analysis defined intraabdominal origin (p = 0.01, OR = 15.7) and presence of shock (p = 0.04, OR = 3.3) as independently influencing the risk of death. No significant differences were found for the remaining variables studied. CONCLUSIONS: Epidemiology and etiology of ICU-acquired bacteremia does not differ seriously in respect to nosocomial bacteremia among unselected populations, although it is associated with a greater incidence and overall mortality. Presence of shock is the most important modificable variable affecting the outcome.
OBJECTIVE: To analyze the epidemiology and factors influencing mortality of ICU-acquired bacteremia. DESIGN: Prospective clinical study. SETTING: A medical-surgical ICU in an university hospital. PATIENTS: We recorded variables from 111 consecutive ICU-acquired episodes for a 3-year period. RESULTS: The attack rate was 1.9 episodes per 100 patient-days. The commonest isolates were coagulase-negative staphylococci, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. Intravascular catheters were the most frequent source of infection. Overall mortality was 31.5%, and 65.7% of all deaths were directly attributable to infection. Bacteremia from intra-abdominal, lower respiratory tract or unknown origin were associated with a poor prognosis. A logistic regression analysis defined intraabdominal origin (p = 0.01, OR = 15.7) and presence of shock (p = 0.04, OR = 3.3) as independently influencing the risk of death. No significant differences were found for the remaining variables studied. CONCLUSIONS: Epidemiology and etiology of ICU-acquired bacteremia does not differ seriously in respect to nosocomial bacteremia among unselected populations, although it is associated with a greater incidence and overall mortality. Presence of shock is the most important modificable variable affecting the outcome.
Authors: T G Emori; D H Culver; T C Horan; W R Jarvis; J W White; D R Olson; S Banerjee; J R Edwards; W J Martone; R P Gaynes Journal: Am J Infect Control Date: 1991-02 Impact factor: 2.918
Authors: E Velasco; M Soares; R Byington; C A S Martins; M Schirmer; L M C Dias; V M S Gonçalves Journal: Eur J Clin Microbiol Infect Dis Date: 2004-07-28 Impact factor: 3.267
Authors: Stephen W Davies; Jimmy T Efird; Christopher A Guidry; Tjasa Hranjec; Rosemarie Metzger; Brian R Swenson; Robert G Sawyer Journal: J Trauma Acute Care Surg Date: 2014-10 Impact factor: 3.313
Authors: Stephen W Davies; Jimmy T Efird; Christopher A Guidry; Tjasa Hranjec; Rosemarie Metzger; Brian R Swenson; Robert G Sawyer Journal: Shock Date: 2014-09 Impact factor: 3.454