Risk Factors for Hospital-acquired Bacteremia

Abstract

Objective Bacteremia is one of the most serious health problems associated with high morbidity and mortality. The aim of this study was to identify risk factors for bacteremia in daily medical care to facilitate rapid and accurate clinical decisions about treatment.Patients and Methods We studied 306 inpatients retrospectively. Age, peripheral neutrophil count, C-reactive protein (CRP), platelets, serum total cholesterol, total protein, albumin and cholinesterase were compared in patients with positive-and negative-blood cultures. The associations between blood culture positivity and glucose tolerance, bedridden state, presence of a central venous catheter (CVC) or urinary catheter were examined. On October 14, 2002, strategies for prevention of catheterrelated infection were altered in our hospital. We studied the impact of these changes on the risk of bacteremia.Results Sixty-seven patients had positive and 239 had negative blood cultures. Age, neutrophil, platelets, total protein, albumin, and cholinesterase were significantly different between the culture-positive patients and the culture-negative patients. Multivariate analysis showed albumin and platelets as independent predictors. The bedridden state and catheter-inserted states (central venous or urinary) conferred significantly higher positive blood culture rates. Multivariate analysis showed using urinary catheters and indwelling femoral CVCs as independent risk factors. There was no significant difference in the blood culture-positive rate before and after the change in prevention strategies; before the change, 6 of 9 catheter-inserted blood culture-positive cases yielded MRSA, while 4 of 12 cultures yielded Staphylococcus epidermidis after the change.Conclusion Our study highlights the risk factors of bacteremia in vulnerable patients. (Internal Medicine 44: 1157-1162, 2005)

Factors Influencing the Development of Nosocomial Pancreatic Infection in Severe Acute Pancreatitis

“…Other invasive procedures such as urinary catheterization and endotracheal intubation might also be assumed as potential source of nosocomial infection [32,33]. However, in our patients these had no significant influence on the infection of necrotic tissue with resistant strands of bacteria.…”

Análise microbiológica de pontas de cateteres venosos centrais provenientes de pacientes internados no Hospital Universitário da Universidade Estadual de Londrina

“…A presença de 15 ou mais UFC em culturas de pontas de cateteres tem sido associada a uma incidência de 16% de bacteremia. Os CVC contribuem com 75 a 90% de todas as infecções da corrente sangüínea, relacionadas a cateteres (EGGIMANN; SAX; PITTET, 2004;YOSHIDA et al, 2005 O processo infeccioso depende da eficiência com que o microrganismo consegue colonizar a pele, causar alterações patológicas no sítio de inserção e disseminarse para a corrente sanguínea, ou a uma nova área. Jarvis (1996) considera que ocorre aumento do risco de infecção em pacientes imunocomprometidos por estados clínicos graves, em portadores de doenças de base e em extremos de idade.…”

Clinical Features of Bacteremia Caused by Methicillin-Resistant Staphylococcus aureus in a Tertiary Hospital

“…A previous study suggested that neutropenia is a factor that contributes to hospital-acquired bacteremia (Yoshida et al 2005). However, there have been no reports describing the relationship between leucopenia and the mortality of MRSA bacteremia.…”