Abstract
Objective
To analyze the epidemiology and factors influencing mortality of ICU-acquired bacteremia.
Design
Prospective clinical study.
Setting
A medical-surgical ICU in an university hospital.
Patients
We recorded variables from 111 consecutive ICU-acquired episodes for a 3-year period.
Results
The attack rate was 1.9 episodes per 100 patientdays. The commonest isolates were coagulase-negative staphylococci,Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. Intravascular catheters were the most frequent source of infection. Overall mortality was 31.5%, and 65.7% of all deaths were directly attributable to infection. Bacteremia from intra-abdominal, lower respiratory tract or unknown origin were associated with a poor prognosis. A logistic regression analysis defined intraabdominal origin (p=0.01, OR=15.7) and presence of shock (p=0.04, OR=3.3) as independently influencing the risk of death. No significant differences were found for the remaining variables studied.Conclusions: Epidemiology and etiology of ICU-acquired bacteremia does not differ seriously in respect to nosocomial bacteremia among unselected populations, although it is associated with a greater incidence and overall mortality. Presence of shock is the most important modificable variable affecting the outcome.
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Rello, J., Ricart, M., Mirelis, B. et al. Nosocomial bacteremia in a medical-surgical intensive care unit: Epidemiologic characteristics and factors influencing mortality in 111 episodes. Intensive Care Med 20, 94–98 (1994). https://doi.org/10.1007/BF01707661
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DOI: https://doi.org/10.1007/BF01707661