Bacteraemia in the Royal Free Hospital 1972–1976

Abeysundere, Rohini L.; Bradley, J. L.; Chipping, P. M.; Rogers, Bogumila T.; Noone, Paul

doi:10.1016/s0163-4453(79)80004-3

Cited by 9 publications

(1 citation statement)

References 9 publications

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“…In 1980, when this survey was started, units dealing with general medicine and surgery, paediatrics, urology, orthopaedics and oncology were operational; obstetric, gynaecology and neonatal units were commissioned in November 1981. Eighty-four per cent of all cases of bacteraemia in this study originated in patients in University Hospital Nottingham, in which the incidence of bacteraemia was 7.1 per 1000 admissions, similar to that reported from other teaching hospitals in the United Kingdom [23,24], but much lower than rates of 12.5 to 28.0 per 1000 admissions for large city and university hospitals in the United States [3,15].…”

Section: Laboratory and Epidemiological Findingssupporting

confidence: 82%

An Analysis of Community and Hospital-acquired Bacteraemia in a Large Teaching Hospital in the United Kingdom

1987

QJM: An International Journal of Medicine

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A total of 875 episodes of bacteraemia and fungaemia were analysed in patients admitted to University Hospital, Nottingham, and three smaller hospitals over a four-year period. In 814 episodes (93 per cent) a single organism was isolated, most commonly Escherichia colt (27'.4 per cent), other enterobacteria (14.4 per cent), Staphylococcus aureus (11.2 per cent), Streptococcus pneumoniae (9.0 per cent), or Haemophilus influenzae (6.4 per cent). In 61 cases (7.0 per cent) bacteraemia was due to two or more species. In almost 60 per cent of cases, bacteraemia was considered to be community-acquired. The most common sources were the urinary (26.9 per cent), respiratory (14.6 per cent), gastrointestinal (11.6 per cent) and biliary (9.5 per cent) tracts, but in almost 10 per cent of cases the focus of infection was unknown. Polymicrobial bacteraemia was common when the biliary tract was the focus of infection. Shock was recorded in 19.5 per cent of cases, and was commoner in polymicrobial (42.9 per cent) than in monomicrobial (17.4 per cent) episodes. In monomicrobial episodes haemolytic streptococci were associated with the highest incidence of shock (30.0 per cent). Mortality directly related to bacteraemia (19.5 per cent) was higher with Gram-positive (23.5 per cent) than with Gram-negative (15.8 per cent) organisms; in polymicrobial (31.1 per cent) than in monomicrobial episodes (18.7 per cent); and in those who had multiple episodes (34.7 per cent) than in those who had a single episode of bacteraemia (20.3 per cent). Other factors influencing mortality included shock, failure to mount an adequate febrile response, leucopenia or granulocytopenia, and underlying disease. Mortality was markedly reduced by appropriate treatment; a single antimicrobial agent was as effective as combination therapy in bacteraemia caused by Gram-negative bacilli.

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Section: Laboratory and Epidemiological Findingssupporting

confidence: 82%

An Analysis of Community and Hospital-acquired Bacteraemia in a Large Teaching Hospital in the United Kingdom

1987

QJM: An International Journal of Medicine

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Retrospective analysis of two hundred and twelve cases of bacteremia due to anaerobic microorganisms

Bouza

Reig

Torre

et al. 1985

Eur. J. Clin. Microbiol.

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Cases of bacteremia caused by anaerobic microorganisms and occurring during a four year period in a non-selected patient group in a Spanish general hospital were analysed retrospectively. Microbiological data was collected on 212 patients and clinical data on 103 patients. Cases of anaerobic bacteremia represented 8.6% of the total number of cases of bacteremia. Of the 232 anaerobic microorganisms causing bacteremia, gram-negative bacilli were responsible in 113 cases (48.7%), gram-positive bacilli in 92 cases (39.6%), gram-positive cocci in 25 cases (10.7%), and Veillonella spp. in two cases (0.8%). The most important clinical features were fever (64%), anemia (56%), septic shock (22%) and metastatic abscesses (21%). Patients with anaerobic bacteremia were hospitalized for an average of 51.7 days. The overall mortality was 32% and factors associated with poor prognosis were severe underlying disease, nosocomial acquisition, presence of shock, presence of metastatic foci of infection, and absence of adequate surgical drainage. The mortality rate of patients who received adequate antimicrobial therapy was 30% and that of patients who received inadequate treatment or none was 29%. It is concluded that anaerobic bacteremia has a significant rate of morbidity and mortality and that underlying disease and surgical debridement and/or drainage have greater prognostic significance than the use of antimicrobial agents.

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Anaerobic bacteremia: Incidence, patient characteristics, and clinical significance

Lombardi¹,

Engleberg

1992

The American Journal of Medicine

120

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The frequency of anaerobic bacteremia in our hospitals is much lower than was suggested in several large studies during the 1970s, probably reflecting a real decline in the incidence. The clinical features of our cases are similar to those of previous studies, and the mortality is still high despite the use of antibiotics effective against anaerobes. Since most patients were thought to have anaerobic infections at the time that cultures were obtained, they were usually treated empirically. Subsequent blood cultures positive for anaerobes infrequently influenced clinical management.

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Bacteraemia in the Royal Free Hospital 1972–1976

Cited by 9 publications

References 9 publications

An Analysis of Community and Hospital-acquired Bacteraemia in a Large Teaching Hospital in the United Kingdom

An Analysis of Community and Hospital-acquired Bacteraemia in a Large Teaching Hospital in the United Kingdom

Retrospective analysis of two hundred and twelve cases of bacteremia due to anaerobic microorganisms

Anaerobic bacteremia: Incidence, patient characteristics, and clinical significance

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