Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/2363
Título : Reappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study.
Autor : Retamar, Pilar
López-Prieto, María Dolores
Nátera, Clara
de Cueto, Marina
Nuño, Enrique
Herrero, Marta
Fernández-Sánchez, Fernando
Muñoz, Angel
Téllez, Francisco
Becerril, Berta
García-Tapia, Ana
Carazo, Inmaculada
Moya, Raquel
Corzo, Juan E
León, Laura
Muñoz, Leopoldo
Rodríguez-Baño, Jesús
Rodríguez-López, Fernando
García, María V
Filiación: [Retamar,P; de Cueto,M; Rodríguez-Baño,J] Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Spain. [López-Prieto,MD] Unidad Clínica de Microbiología y Enfermedades Infecciosas, Hospital del SAS, Jerez de la Frontera, Cádiz, Spain. [Nátera,C] Sección Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, Spain. [Nuño,E] Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Herrero,M] Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Sevilla, Spain. [Fernández-Sánchez,F] Servicio de Microbiología, Hospital Costa del Sol, Marbella, Málaga, Spain. [Muñoz,A] Servicio de Medicina Interna, Hospital de la Serranía, Ronda, Málaga, Spain. [Téllez,F] Unidad de Enfermedades Infecciosas, Hospital de La Línea, Cádiz, Spain. [Becerril,B] Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Punta de Europa, Algeciras, Cádiz, Spain. [García-Tapia,A] Servicio de Microbiología, Hospital Puerta del Mar, Cádiz, Spain. [Carazo,I] Servicio de Microbiología, Complejo Hospitalario de Jaén, Jaén, Spain. [Moya,R] Servicio de Medicina Interna, Hospital de Antequera, Málaga, Spain. [Corzo,JE] Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain. [León,L] Servicio de Enfermedades Infecciosas, Hospital Torrecárdenas, Almería, Spain. [Muñoz,L] Unidad de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain. [García,MV] Department of Medicine, University of Seville, Seville, Spain.
Grupo de Investigación: The Sociedad Andaluza de Enfermedades Infecciosas/Sociedad Andaluza de Microbiología y Parasitología Clínica and Red Española de Investigación en Enfermedades Infecciosas (SAEI/SAMPAC/REIPI) Bacteremia Group
Palabras clave : Bloodstream infections
Antimicrobial therapy
Bacteremia
Community-acquired
Healthcare-associated
Mortality
Outcome
Antimicrobial resistance
Análisis de varianza
Antibacterianos
Infecciones comunitarias Adquiridas
Infección hospitalaria
Farmacorresistencia Bacteriana
Estudios prospectivos
Resultado del tratamiento
MeSH: Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Community-Acquired Infections
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection
Medical Subject Headings::Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic Models
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Sensitivity and Specificity::ROC Curve
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Fecha de publicación : 24-Jul-2013
Editorial : BioMed Central
Cita Bibliográfica: Retamar P, López-Prieto MD, Nátera C, de Cueto M, Nuño E, Herrero M, et al. Reappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study. BMC Infect. Dis. 2013; 13:344
Abstract: BACKGROUND Healthcare-associated (HCA) bloodstream infections (BSI) have been associated with worse outcomes, in terms of higher frequencies of antibiotic-resistant microorganisms and inappropriate therapy than strict community-acquired (CA) BSI. Recent changes in the epidemiology of community (CO)-BSI and treatment protocols may have modified this association. The objective of this study was to analyse the etiology, therapy and outcomes for CA and HCA BSI in our area. METHODS A prospective multicentre cohort including all CO-BSI episodes in adult patients was performed over a 3-month period in 2006-2007. Outcome variables were mortality and inappropriate empirical therapy. Adjusted analyses were performed by logistic regression. RESULTS 341 episodes of CO-BSI were included in the study. Acquisition was HCA in 56% (192 episodes) of them. Inappropriate empirical therapy was administered in 16.7% (57 episodes). All-cause mortality was 16.4% (56 patients) at day 14 and 20% (71 patients) at day 30. After controlling for age, Charlson index, source, etiology, presentation with severe sepsis or shock and inappropriate empirical treatment, acquisition type was not associated with an increase in 14-day or 30-day mortality. Only an stratified analysis of 14th-day mortality for Gram negatives BSI showed a statically significant difference (7% in CA vs 17% in HCA, p = 0,05). Factors independently related to inadequate empirical treatment in the community were: catheter source, cancer, and previous antimicrobial use; no association with HCA acquisition was found. CONCLUSION HCA acquisition in our cohort was not a predictor for either inappropriate empirical treatment or increased mortality. These results might reflect recent changes in therapeutic protocols and epidemiological changes in community pathogens. Further studies should focus on recognising CA BSI due to resistant organisms facilitating an early and adequate treatment in patients with CA resistant BSI.
Descripción : Journal Article; Research Support, Non-U.S. Gov't;
URI: http://hdl.handle.net/10668/2363
Versión del editor : http://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-13-344#Abs1
DOI: 10.1186/1471-2334-13-344
ISSN : 1471-2334 (Online)
Appears in Collections:01- Artículos - Hospital San Cecilio
01- Artículos - Complejo Hospitalario Torrecárdenas
01- Artículos - Hospital de Valme
01- Artículos - AGS Norte de Málaga
01- Artículos - Complejo Hospitalario de Jaén
01- Artículos - Hospital Puerta del Mar
01- Artículos - AGS Campo de Gibraltar
01- Artículos - AGS Serranía de Málaga
01- Artículos - APES Costa del Sol
01- Artículos - Hospital Virgen del Rocío
01- Artículos - Hospital Virgen de la Victoria
01- Artículos - Hospital Reina Sofía
01- Artículos - Hospital de Jerez
01- Artículos - Hospital Virgen Macarena

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