Epidemiología y factores de riesgo de mortalidad de las bacteriemias intrahospitalarias por bacilos gramnegativos

Abstract

Nosocomial bloodstream infections caused by gram-negative bacilli: epidemiology and risk factors for mortality Nosocomial bacteremia is a major cause of hospital infection, associated with high rate of morbidity and mortality, prolonged hospital stay and higher costs. However, few prospective studies analyse the prognostic factors associated with mortality of gramnegative rods bloodstream infections in hospital wards outside of intensive care units. A prospective/descriptive study was conducted from March to December 2006. All patients with nosocomial-acquired bloodstream infection due to gramnegative rods were included. Epidemiology and clinical features were analysed as potential prognostic factors for mortality. During the study period, 84 cases were detected, being A. baumannii, Burkholderia sp and E. coli the most frequent isolates, with a mortality of 48%. Bacteremia derived from a high-mortality associated septic focus (RR 4.9, IC95% 1.3-18.8) and admission to intensive care unit (RR 4.78, IC95% 1.7-13.1) were independent variables associated with mortality. Inappropriate empirical antibiotic treatment was not associated with greater risk of mortality. Nosocomial gramnegative bloodstream infections in our series were mainly due to non-fermentative bacilli and were associated with high mortality rates when their origin was a high risk septic focus or the patient was admitted to intensive care unit.

Frequency of microorganisms isolated in patients with bacteremia in intensive care units in Colombia and their resistance profiles

“…Bacteremia acquired in the hospital is a frequent cause of morbidity and mortality in intensive care units (ICU)], 1 having an important clinical impact on patients’ length of stay and costs associated with health care. 1 , 2 According to the World Health Organization (WHO), 8.7% of hospital acquired infections correspond to bacteremia 2 and retrospective studies have shown that the incidence of nosocomial bacteremia is close to six episodes per 1000 hospital admissions. ICU ranks first amongst hospital services (51% of events) followed by adult internal medicine services (38%), surgical services (20%) and paediatric rooms (13.5%).…”

“…ICU ranks first amongst hospital services (51% of events) followed by adult internal medicine services (38%), surgical services (20%) and paediatric rooms (13.5%). 1 , 2 It has been reported that ICU patients present a greater tendency for developing episodes of nosocomial bacteremia compared to those admitted to different hospital wards. 3 This is related to patients’ susceptibility due to immunosuppression and frequent use of invasive devices, such as intravascular and urinary catheters, and tubes for supporting mechanical ventilation.…”