| Autor: |
J, Rodríguez-Baño, M D, López-Prieto, M M, Portillo, P, Retamar, C, Natera, E, Nuño, M, Herrero, A, del Arco, A, Muñoz, F, Téllez, M, Torres-Tortosa, A, Martín-Aspas, A, Arroyo, A, Ruiz, R, Moya, J E, Corzo, L, León, J A, Pérez-López, Inmaculada, Carazo |
| Rok vydání: |
2009 |
| Předmět: |
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| Zdroj: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 16(9) |
| ISSN: |
1469-0691 |
| Popis: |
Classification of bloodstream infections (BSIs) as community-acquired (CA), healthcare-associated (HCA) and hospital-acquired (HA) has been proposed. The epidemiology and clinical features of BSI according to that classification in tertiary-care (TH) and community (CH) hospitals were investigated in a prospective cohort of 821 BSI episodes from 15 hospitals (ten TH and five CH hospitals) in Andalucía, Spain. Eighteen percent were CA, 24% were HCA and 58% were HA. The incidence of CA and HCA BSI was higher in CH than in TH (CA: 3.9 episodes per 1000 admissions vs. 2.2, p0.01; HCA: 5.0 vs. 2.9, p0.01), whereas the incidence of HA BSI was lower (7.7 vs. 8.7, p0.01). In CA and HCA BSI, the respiratory tract was more frequently the source in CH than in TH (CA: 30% vs. 15%; HCA: 20% vs. 9%, p ≤0.03). In HCA BSI, chronic renal insufficiency and tunnelled catheters were less frequent in CH than in TH (11% vs. 26% and 7% vs. 19%, p ≤0.03), although chronic ulcers were more frequent (22% vs. 8%, p 0.008). BSIs as a result of methicillin-resistant Staphylococcus aureus or Pseudomonas aeruginosa were very rare in CA episodes, although extended-spectrum b-lactamase-producing Escherichia coli (ESBLEC) caused a similar proportion of all BSIs in CA, HCA and HA episodes. Multivariate analysis revealed no significant difference in mortality rates in CH and TH. HCA infections should be considered as a separate class of BSI in both TH and CH, although differences between hospitals must be considered. CA BSIs were not caused by multidrug-resistant pathogens, except for ESBLEC. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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