Impact of primary and intravascular catheter-related bacteremia due to coagulase-negative staphylococci in critically ill patients

被引：17
作者：
Olaechea, P. M. [1 ]
Alvarez-Lerma, F. [2 ]
Palomar, M. [3 ]
Insausti, J. [4 ]
Lopez-Pueyo, M. J. [5 ]
Martinez-Pellus, A. [6 ]
Canton, M. L. [7 ]
机构：
[1] Hosp Galdakao Usansolo, Serv Med Intens, Vizcaya, Spain
[2] Hosp del Mar, Serv Med Intens, Barcelona, Spain
[3] Hosp Valle De Hebron, Serv Med Intens, Barcelona, Spain
[4] Hosp Navarra, Serv Med Intens, Navarra, Spain
[5] Hosp Gen Yague, Serv Med Intens, Burgos, Spain
[6] Hosp Virgen Arrixaca, Serv Med Intens, Murcia, Spain
[7] Hosp Virgen Macarena, Serv Med Intens, Seville, Spain
来源：
MEDICINA INTENSIVA | 2011年 / 35卷 / 04期
关键词：
Primary bacteremia; Catheter-related bacteremia; Coagulase-negative staphylococcus; Mortality; Morbidity; BLOOD-STREAM INFECTIONS; INTENSIVE-CARE-UNIT; CLINICAL-SIGNIFICANCE; NOSOCOMIAL INFECTION; HOSPITAL STAY; MORTALITY; SURVEILLANCE; CULTURES; SYSTEM; DEATH;
D O I：
10.1016/j.medin.2010.09.002
中图分类号：
R4 [临床医学];
学科分类号：
1002 ; 100602 ;
摘要：
Objective: To study the impact of coagulase-negative staphylococcal (CNS) primary and intravascular catheter-related bloodstream infection (PBSI/CRBSI) on mortality and morbidity in critically-ill patients. Design: We performed a double analysis using data from the ENVIN-HELICS registry data (years 1997 to 2008): 1) We studied the clinical characteristics and outcomes of patients with CNS-induced PBSI/CRBSI and compared them with those of patients with PBSI/CRBSI caused by other pathogens; and 2) We analyzed the impact of CNS-induced PBSI/CRBSI using a case-control design (1:4) in patients without other nosocomial infections. Setting: 167 Spanish Intensive Care Units. Patients: Patients admitted to ICU for more than 24 hours. Results: 2,252 patients developed PBSI/CRBSI, of which 1,133 were caused by CNS. The associated mortality for PBSI/CRBSI caused by non-CNS pathogens was higher than that of the CNS group (29.8% vs. 25.9%; P=.039) due exclusively to the mortality of patients with candidemia (mortality: 45.9%). In patients without other infections, PBSI/CRBSI caused by CNS (414 patients) is an independent risk factor for a higher than average length of ICU stay (OR: 5.81, 95% CI: 4.31-7.82; P<.001). Conclusion: Crude mortality of patients with CNS-induced BPSI/CRBSI is similar to that of patients with BPSI/CRBSI caused by other bacteria, but lower than that of patients with candidemia. Compared to patients without nosocomial infections, CNS-induced PBSI/CRBSI is associated with a significant increase in length of ICU stay (C) 2010 Elsevier Espana, S.L. y SEMICYUC. All rights reserved.
引用
收藏
页码：217 / 225
页数：9
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