Four year prospective evaluation of nosocomial bacteremia: epidemiology, microbiology, and patient outcome

Lark, Rebecca L.; Chenoweth, Carol E.; Saint, Sanjay; Zemencuk, Judith K.; Lipsky, Benjamin A.; Plorde, James J.

doi:10.1016/s0732-8893(00)00192-9

Cited by 75 publications

(62 citation statements)

References 26 publications

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“…Lark et al [32] observed bacteremia without documented origin to a lesser extent (7.0%) and at different incidences; in that study, catheters were linked in 47.0% of the episodes, while urinary infections had a lower incidence (11.0%) after intra-abdominal sites, pneumonia, and skin or softtissue infections. However, a previous study conducted in Argentina reported a similar frequency (42.0%) to that of this study of bacteremia of unknown source, followed by respiratory, urinary, skin, and abdominal origin [31].…”

Section: Discussionmentioning

confidence: 76%

“…In Denmark, trends in microbiological agents of nosocomial and community-acquired bacteremia were investigated. Through a nine-year period, the incidence of enterococcal bacteremia increased to 13.0%, mainly due to an increase of E. faeciumassociated episodes, rising from the fourth-most to the third-most frequent agents of nosocomial bacteremia [32,33].…”

Section: Discussionmentioning

confidence: 99%

“…This prevalence of ICU patients is higher than that reported by other researchers. In a survey conducted at an American hospital, 33.9% of bacteremic episodes were found to be associated with patients hospitalized in an ICU [32]. In a prospective multicenter cohort study, it was shown that 10.0% of very elderly patients with bacteremia were admitted to the ICU.…”

Section: Discussionmentioning

confidence: 99%

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Clinical and microbiological features of bacteremia caused by Enterococcus faecalis

Ceci

Delpech

Sparo

et al. 2015

J Infect Dev Ctries

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Introduction: Enterococcus faecalis is a frequent etiologic agent of invasive infections in hospitalized patients. The aim of this study was to analyze clinical and microbiological features of bacteremia caused by E. faecalis. Methodology: Between 2011 and 2013, significant bacteremia caused by E. faecalis in hospitalized patients was studied. Patient characteristics, comorbid conditions, and 14-day mortality were recorded. Virulence genes esp, gelE, and cylA; opsonophagocytosis resistance; resistance to bactericidal effect of normal serum; beta lactamase production; and susceptibility to ampicillin, vancomycin, teicoplanin, gentamicin, and streptomycin were investigated. Results: E. faecalis strains were recovered from 33 bacteremic patients. Polymicrobial bacteremia was diagnosed in 2 patients; 10 patients died. Virulence genes were found in strains from both deceased patients and survivors. Sources of bacteremia included urinary tract infections (36.4%), vascular catheters (15.1%), abscesses (9.1%), and unknown (48.5%). Underlying diseases included cancer (30.3%), diabetes (36.4%), cirrhosis (6.1%), renal (36.4%), and chronic obstructive pulmonary disease (2.0%). Co-morbidities included alcohol use (26.1%); glucocorticoid therapy (19.0%); prior antibiotic therapy (60.6%); and central venous (21.2%), arterial (12.1%), and urinary (63.6%) catheters. Also, 57.6% of patients came from the intensive care unit (ICU); 33.3% had mechanical ventilation. Significant mortalityassociated conditions included polymicrobial bacteremia, oncological disease, APACHE II score ≥ 20, ICU stay, renal disease, central venous catheter, and mechanical ventilation. Conclusions: Outcome of patients was associated with their status and not with the presence of virulence genes in E. faecalis strains. A significant percentage of bacteremia had undetermined origin. An alternate origin may be the gastrointestinal tract, through translocation.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical and microbiological features of bacteremia caused by Enterococcus faecalis

Ceci

Delpech

Sparo

et al. 2015

J Infect Dev Ctries

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“…Risk factors for invasive S. aureus infection include nasal colonization [6][7][8], advanced HIV disease [2,3,9], prior hospitalization, neutropenia, skin lesions, injecting drug use (IDU) and the presence of intravascular devices [3,4,[10][11][12]. Further, HIV infection is associated with a higher risk of repetitive SAB [13].…”

Section: Introductionmentioning

confidence: 99%

Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study^*

et al. 2011

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all Danish HIV-infected individuals (n 5 4871) and population controls (n 5 92 116) matched on age and sex were enrolled in a cohort and all cases of SAB were registered. IRs and risk factors were estimated using time-updated Poisson regression analysis. ResultsWe identified 329 cases of SAB in 284 individuals, of whom 132 individuals were infected with HIV and 152 were not [crude IR ratio (IRR) 24.2; 95% confidence interval (CI) 19.5-30.0, for HIV-infected vs. non-HIV-infected individuals]. Over time, IR declined for HIV-infected individuals (IRR 0.40). Injecting drug users (IDUs) had the highest incidence and the smallest decline in IR, while men who have sex with men (MSM) had the largest decline over time. Among HIV-infected individuals, a latest CD4 count o100 cells/mL was the strongest independent predictor of SAB (IRR 10.2). Additionally, HIV transmission group was associated with risk of SAB. MSM were more likely to have hospital-acquired SAB, a low CD4 cell count and AIDS at the time of HIV acquisition compared with IDUs. ConclusionsWe found that the incidence of SAB among HIV-infected individuals declined during the study period, but remained higher than that among HIV-uninfected individuals. There was an unevenly distributed burden of SAB among HIV transmission groups (IDU4MSM). Low CD4 cell count and IDU were strong predictors of SAB among HIV-infected individuals.

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“…3 Through the certain types of microbial flora of hospitals and health workers, these immune suppressed patients are colonized with different types of candida and bacteria. [4][5][6][7][8] The most frequent site of colonization is the oropharynx which allows easy access to the clinicians to take samples. Most of the time, colonization is necessary before infection.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Oropharyngeal Candida and Bacterial Colonization in Cancer Patients

Şenler¹

2012

UHOD

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Changes occur in the oropharyngeal flora of the cancer patients due to disease and treatment related factors. In this study, bacterial and candidal colonizations were evaluated in 119 cancer patients from the two clinics (Ibni Sina Hospital is old clinic and Cebeci Hospital is new clinic) of the Medical Oncology Department of Ankara University Medical Faculty. Throat swabs and cultures were obtained from all patients on days 0, 4 and 7 of admission. The clinical parameters that can effect colonization like age, sex, use of steroids and antibiotics, chemotherapy, catheterization/TPN (total parenteral nutrition) procedures, ECOG performance status and number of admissions were recorded. The distribution of detected microorganisms and the differences in subsequent days were evaluated. There were no significant differences between two hospitals with regard to bacterial and candidal colonizations on the 1st, 4th and 7th days. The performance status, catheterization/TPN procedures, usage of antibiotics and chemotherapy are found to be the significant clinical parameters that can effect colonizations. Keywords: Oropharyngeal colonization, Cancer, Surveillance ÖZET Kanser Hastalar›nda Orofaringeal Kandida ve Bakteriyel Kolonizasyonun ÖzellikleriKanser hastalar›nda hastal›¤a ve tedavilere ba¤l› faktörler nedeniyle, orofaringeal florada de¤ifliklikler olmaktad›r. Bu çal›flmada, Ankara Üniversitesi T›p Fakültesi T›bbi Onkoloji Bilim Dal›'n›n iki klini¤inden (‹bni Sina Hastanesi ve Cebeci Hastanesi) toplam 119 hastada bakteriyel ve kandida kolonizasyonlar› incelendi. ‹lk 24. saatte, 4.gün ve 7.günde bo¤azdan sürveyans kültürü amaç-l› sürüntü al›nd›. Yafl, cinsiyet, steroid, antibiyotik kullan›m›, kemoterapi, kateter/total parenteral nütrisyon uygulamalar›, ECOG performans statusu ve daha önceki yat›fl say›s› gibi kolonizasyonu etkileyebilecek klinik parametreler kaydedildi. Saptanan mikroorganizmalar›n da¤›l›m›na, günlere göre de¤iflikli¤ine bak›ld›. ‹bni Sina ve Cebeci Hastaneleri aras›nda hem bakteriyel hem de kandida kolonizasyonu aç›s›ndan 1, 4. ve 7. günlerde anlaml› farkl›l›k saptanmad›. Kolonizasyonu etkiledi¤i belirlenen en önemli klinik özellikler performans statusu, kateter-TPN (total parenteral nütrisyon), antibiyotik ve kemoterapi kullan›m› idi.

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Four year prospective evaluation of nosocomial bacteremia: epidemiology, microbiology, and patient outcome

Cited by 75 publications

References 26 publications

Clinical and microbiological features of bacteremia caused by Enterococcus faecalis

Clinical and microbiological features of bacteremia caused by Enterococcus faecalis

Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study^*

Characteristics of Oropharyngeal Candida and Bacterial Colonization in Cancer Patients

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Four year prospective evaluation of nosocomial bacteremia: epidemiology, microbiology, and patient outcome

Cited by 75 publications

References 26 publications

Clinical and microbiological features of bacteremia caused by Enterococcus faecalis

Clinical and microbiological features of bacteremia caused by Enterococcus faecalis

Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study*

Characteristics of Oropharyngeal Candida and Bacterial Colonization in Cancer Patients

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Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study^*