Bloodstream infections and setting of onset in persons with spinal cord injury and disorder

Evans, Charlesnika T.; Hershow, Ronald C.; Chin, Amy; Foulis, Philip; Burns, Stephen P.; Weaver, Frances M.

doi:10.1038/sc.2009.2

Cited by 14 publications

(15 citation statements)

References 20 publications

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“…Studies not limited to specific etiologies are summarized in Table 2 (50,(65)(66)(67)(68)(69)(70). While definitions and study populations have varied to some degree, compared to community-associated BSIs, health care-associated BSIs are more likely in older patients with comorbid illness, have a different distribution of pathogens (higher rates of Staphylococcus aureus and Pseudomonas aeruginosa and lower rates of Streptococcus pneumoniae and Escherichia coli), have higher rates of antimicrobial resistance, and are more lethal (65).…”

Section: Classification Of Community-onset Bloodstream Infectionsmentioning

confidence: 99%

Population-Based Epidemiology and Microbiology of Community-Onset Bloodstream Infections

2014

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SUMMARY Bloodstream infection (BSI) is a major cause of infectious disease morbidity and mortality worldwide. While a positive blood culture is mandatory for establishment of the presence of a BSI, there are a number of determinants that must be considered for establishment of this entity. Community-onset BSIs are those that occur in outpatients or are first identified <48 h after admission to hospital, and they may be subclassified further as health care associated, when they occur in patients with significant prior health care exposure, or community associated, in other cases. The most common causes of community-onset BSI include Escherichia coli , Staphylococcus aureus , and Streptococcus pneumoniae . Antimicrobial-resistant organisms, including methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase/metallo-β-lactamase/carbapenemase-producing Enterobacteriaceae , have emerged as important etiologies of community-onset BSI.

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Section: Classification Of Community-onset Bloodstream Infectionsmentioning

confidence: 99%

Population-Based Epidemiology and Microbiology of Community-Onset Bloodstream Infections

2014

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“…Seven studies were found addressing BSI, including four retrospective cohort studies 5,15,18,19 and three case series. 8,9,12 All were in adult populations, and four were in veteran's administration (VA) patient populations.…”

Section: Bloodstream Infections (Bsi)mentioning

confidence: 99%

“…Three of the cohort studies were by the same group of investigators, Evans et al 5,15,19 who examined BSI in VA patients with SCI. The first was a retrospective cohort examining healthcare-associated infections in that population, 19 another was a multi-center descriptive study of the SCI population, 19 and the last examined the effect of inadequate initial treatment.…”

Section: Bloodstream Infections (Bsi)mentioning

confidence: 99%

“…8,9,12 All were in adult populations, and four were in veteran's administration (VA) patient populations. 12,15,18,19 Study characteristics, microbiology and findings are summarized in Table 1.…”

Section: Bloodstream Infections (Bsi)mentioning

confidence: 99%

“…The first was a retrospective cohort examining healthcare-associated infections in that population, 19 another was a multi-center descriptive study of the SCI population, 19 and the last examined the effect of inadequate initial treatment. 15 These studies reported a relatively high rate of BSI in this population at 6.0, 7.2 and 10.7 episodes per 100 admissions, with a predominance of bacteremia cases being healthcare-associated infections.…”

Section: Bloodstream Infections (Bsi)mentioning

confidence: 99%

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Infections in the spinal cord-injured population: a systematic review

et al. 2016

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Study Design: Spinal cord injury (SCI) patients are an increasing population due to recent military conflicts. SCI patients are at an increased risk of infection, but the epidemiology management and prevention strategies for these infections are unclear. Objective: To review the incidence, microbiology and management of pneumonia, skin and soft tissue infections (SSTI), urinary tract infections (UTI) and bloodstream infections in the SCI population via literature review. Methods: With the assistance of an experienced medical librarian, we developed a search strategy for the Ovid MEDLINE database and then adapted it for the Ovid Embase, Scopus and Web of Science databases. The databases were searched from their inception to April 2014 with no restrictions on language or time period. Data were extracted using a standardized form. All studies were reviewed by two independent investigators. Results: Forty-one studies reporting on the described infections were identified. UTIs were the most commonly identified infections, but studies failed to identify consistently effective preventive strategies. SSTIs were also common, and the best preventive strategies focused on decubitus ulcer prevention and skin decolonization protocols. Pneumonia management and course were not significantly different from the general population. Bloodstream infections were associated with delays in recognition, and were most often secondary to UTI, pneumonia or SSTI. Conclusion: There is a paucity of literature on consistently effective infection prevention strategies in SCI patients. Identification and implementation of evidence-based interventions that optimize prevention and management of infections in this patient population are needed. Spinal Cord (2017) 55, 526-534; doi:10.1038/sc.2016.173; published online 6 December 2016 INTRODUCTIONSpinal cord injury (SCI) is a medically complex and life-disrupting condition affecting about a quarter million Americans. 1 Its incidence varies widely from country to country, but~12 000 new cases are reported each year in the United States, with a recent increase most likely associated with present military conflicts. 2,3 SCI is the result of a trauma at any level of the spinal cord causing temporary or permanent damage. Motor vehicle accidents, falls and gunshot wounds are some of the most common causes of SCI among the civilian population, responsible for 39%, 28% and 14% of cases, respectively. 3 Individuals with SCI are at high risk for both community-acquired and healthcare-associated infections due to factors such as frequent contact with the healthcare system and frequent and chronic use of invasive medical devices such as urinary and intravascular catheters. 4,5 This population is also vulnerable by limitations in clearing the airway of secretions due to restricted breathing, and abnormal sensation leading to altered or absent symptoms to indicate early infection. Bloodstream infection (BSI) is one of the most common infections leading to hospital admission, followed by urinary tract infection ...

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