Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/2363
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dc.contributor.authorRetamar, Pilar-
dc.contributor.authorLópez-Prieto, María Dolores-
dc.contributor.authorNátera, Clara-
dc.contributor.authorde Cueto, Marina-
dc.contributor.authorNuño, Enrique-
dc.contributor.authorHerrero, Marta-
dc.contributor.authorFernández-Sánchez, Fernando-
dc.contributor.authorMuñoz, Angel-
dc.contributor.authorTéllez, Francisco-
dc.contributor.authorBecerril, Berta-
dc.contributor.authorGarcía-Tapia, Ana-
dc.contributor.authorCarazo, Inmaculada-
dc.contributor.authorMoya, Raquel-
dc.contributor.authorCorzo, Juan E-
dc.contributor.authorLeón, Laura-
dc.contributor.authorMuñoz, Leopoldo-
dc.contributor.authorRodríguez-Baño, Jesús-
dc.contributor.authorRodríguez-López, Fernando-
dc.contributor.authorGarcía, María V-
dc.date.accessioned2016-08-10T10:21:34Z-
dc.date.available2016-08-10T10:21:34Z-
dc.date.issued2013-07-24-
dc.identifier.citationRetamar 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; 13:344es
dc.identifier.issn1471-2334 (Online)-
dc.identifier.otherPMC3728109-
dc.identifier.urihttp://hdl.handle.net/10668/2363-
dc.descriptionJournal Article; Research Support, Non-U.S. Gov't;es
dc.description.abstractBACKGROUND 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.es
dc.description.sponsorshipThis study was funded by the Ministerio de Economía y Competividad, Instituto de Salud Carlos III - co-financed by the European Development Regional Fund "A way to achieve Europe" ERDF, Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Fondo de Investigación Sanitaria (grant 10/02021), and Junta de Andalucía (grant 0063/2006 and 0185/2010).es
dc.language.isoenes
dc.publisherBioMed Centrales
dc.relation.ispartofBMC Infectious Diseaseses
dc.subjectBloodstream infectionses
dc.subjectAntimicrobial therapyes
dc.subjectBacteremiaes
dc.subjectCommunity-acquiredes
dc.subjectHealthcare-associatedes
dc.subjectMortalityes
dc.subjectOutcomees
dc.subjectAntimicrobial resistancees
dc.subjectAnálisis de varianzaes
dc.subjectAntibacterianoses
dc.subjectInfecciones comunitarias Adquiridases
dc.subjectInfección hospitalariaes
dc.subjectFarmacorresistencia Bacterianaes
dc.subjectEstudios prospectivoses
dc.subjectResultado del tratamientoes
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variancees
dc.subject.meshMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agentses
dc.subject.meshMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremiaes
dc.subject.meshMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Community-Acquired Infectionses
dc.subject.meshMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Cross Infectiones
dc.subject.meshMedical Subject Headings::Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacteriales
dc.subject.meshMedical Subject Headings::Check Tags::Femalees
dc.subject.meshMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humanses
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic Modelses
dc.subject.meshMedical Subject Headings::Check Tags::Malees
dc.subject.meshMedical 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 Studieses
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Sensitivity and Specificity::ROC Curvees
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factorses
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcomees
dc.subject.meshMedical Subject Headings::Named Groups::Persons::Age Groups::Adultes
dc.titleReappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study.es
dc.typeinfo:eu-repo/semantics/articlees
dc.description.versionYeses
dc.contributor.groupThe Sociedad Andaluza de Enfermedades Infecciosas/Sociedad Andaluza de Microbiología y Parasitología Clínica and Red Española de Investigación en Enfermedades Infecciosas (SAEI/SAMPAC/REIPI) Bacteremia Groupes
dc.identifier.pmid23883281-
dc.rights.accessRightsAcceso abiertoes
dc.identifier.doi10.1186/1471-2334-13-344-
dc.type.versioninfo:eu-repo/semantics/publishedes
dc.relation.publisherversionhttp://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-13-344#Abs1es
dc.contributor.authoraffiliation[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.es
dc.type.subtypeArtículoes
Appears in Collections:01- Artículos - Hospital San Cecilio
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