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

页码：217 / 225

页数：9