RT Journal Article
T1 Reappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study.
A1 Retamar, Pilar
A1 López-Prieto, María Dolores
A1 Nátera, Clara
A1 de Cueto, Marina
A1 Nuño, Enrique
A1 Herrero, Marta
A1 Fernández-Sánchez, Fernando
A1 Muñoz, Angel
A1 Téllez, Francisco
A1 Becerril, Berta
A1 García-Tapia, Ana
A1 Carazo, Inmaculada
A1 Moya, Raquel
A1 Corzo, Juan E
A1 León, Laura
A1 Muñoz, Leopoldo
A1 Rodríguez-Baño, Jesús
A1 Rodríguez-López, Fernando
A1 García, María V
K1 Bloodstream infections
K1 Antimicrobial therapy
K1 Bacteremia
K1 Community-acquired
K1 Healthcare-associated
K1 Mortality
K1 Outcome
K1 Antimicrobial resistance
K1 Análisis de varianza
K1 Antibacterianos
K1 Infecciones comunitarias Adquiridas
K1 Infección hospitalaria
K1 Farmacorresistencia Bacteriana
K1 Estudios prospectivos
K1 Resultado del tratamiento
AB BACKGROUNDHealthcare-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.METHODSA 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.RESULTS341 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.CONCLUSIONHCA 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.
PB BioMed Central
YR 2013
FD 2013-07-24
LK http://hdl.handle.net/10668/2363
UL http://hdl.handle.net/10668/2363
LA en
NO 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
NO Journal Article; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 6, 2025