Περίληψη:
Epidemiological and clinical features were studied as potential
prognostic factors for outcomes of bacteraemic patients in a tertiary
care teaching hospital in Greece. The prospective study was conducted
over 12 months and enrolled 153 consecutive hospital-acquired
bacteraemic episodes in 137 patients. The crude in-hospital mortality
rate was 27% (37/137). The mean lengths of stay and of antimicrobial
treatment were significantly longer for patients with a fatal outcome
than for survivors (P<0.0001 and P=0.001, respectively). Needs for
mechanical ventilation, urinary catheters and parenteral nutrition
before or during the onset of episodes were significantly associated
with fatalities [odds ratio (OR) = 5.54, 95% confidence intervals
(CI) 2.22-14.0, P<0.0001; OR 0.70, 95% CI 0.63-0.79, P=0.021; OR=5.03,
95% CI 1.88-13.95, P<0.0001, respectively]. Also, in logistic
regression analysis, mechanical ventilation (OR=5.5, 95% CI 1.2-7.9,
P=0.02) and parenteral nutrition (OR=8.8, 95% CI 3.8-11.4, P=0.003)
were independent predictors of mortality. No differences between
fatalities and survivors were found in sex, age, smoking habit,
intensive care unit hospitalization, need for a nasogastric catheter and
previous surgery. Neutropenia was associated with a fatal outcome
(OR=3.65, 95% Cl 1.24-10.91, P=0.006). None of the bacterial pathogens
were significantly associated with an adverse outcome, whereas
Staphylococcus aureus was recovered more frequently from survivors
(P=0.02). Fatalities were more often associated with an intravascular
catheter origin (P=0.002), whereas bacteraemias in survivors were
associated with a skin/soft tissue origin (P=0.02). Various prognostic
factors were associated with outcome in our bacteraemic population, and
can be employed to identify bacteraemic patients at risk of death and to
develop local strategies for its prevention. (c) 2005 The Hospital
Infection Society. Published by Elsevier Ltd. All rights reserved.
Συγγραφείς:
Arvanitidou, M
Katikaridou, E
Douboyas, J
Tsakris, A
