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P006: Highlights in bloodstream infections: where does the patient acquire the infection?
© Rodriguez-Aguirregabiria et al; licensee BioMed Central Ltd. 2013
Published: 20 June 2013
Bloodstream infections (BSI) still account for significant morbidity and mortality.
The objective of this study was to describe the epidemiology, etiology, sources and adequacy of empiric antimicrobial treatment in BSI.
A retrospective study about all BSI diagnosed during one year. The pattern resistant pathogen study was EPINE-EPPS project.
340 patients were included. Median age was 74.5 years [interquartile range (IQR), 58.5-80.5]; acute physiology and chronic health evaluation (APACHE II) score was 13 (IQR, 7-29).
BSI were community-acquired in 56% of the cases. The most common source of BSI was urinary tract (48.3%), intra-abdominal (25.6%) and lower respiratory tract infections (18.6%). The most commonly isolated microorganisms were: Escherichia coli, K. pneumoniae, S.aureus (15% oxacilin resistant) and S. pneumoniae. The 8.6% of enterobacteracea family produced extended-spectrum B-lactamasas (ESBLs). Inappropriate treatment was observed in 24.5% and crude mortality rate was 7.7%.
28% BSI were nosocomial-acquired. The sources of BSI were unknown in 31.7% of the cases and catheter-related in 25.7%. The secondary sources of BSI were intra-abdominal in 57% of the cases. The most common isolated microorganisms were: S.epidermidis and other coagulasa negative, Candida, S. aureus (36% oxacilin resistant) and E. coli. 25% of enterobacteracea family were ESBLs. We found 5 BSI caused by Acitetobacter carbapenem (CPM) resistant and 2 BSI by P. aeruginosa CPM resistant. Inappropriate treatment was observed in 52.5% and mortality rate was 28.7%.
Health-care related BSI produced 15.1% of the cases. The source of BSI were unknown in 22.6% and catheter- related in 11.3%. The secondary sources of BSI were urinary tract (60%), intra-abdominal (31.4%) and respiratory tract infections(8.6%). The most common microorganisms were: E.coli, S.aureus (25% oxacilin resistant), S.epidermidis and K.pneumoniae. Inappropriate treatment was noticed in 34% and mortality rate was 17%.
The knowledge of local epidemiology is a capital information to improve empiric antimicrobial treatment and to reduce mortality-related inappropriate treatment.
Disclosure of interest
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.