Recurrent bacteraemia: A 10-year regional population-based study of clinical and microbiological risk factors - 07/08/11
Summary |
Background |
A population-based nested case-control study was conducted in order to characterize patient factors and microbial species associated with recurrent bacteraemia.
Methods |
All patients with bacteraemia in a Danish region during 1996–2006 were investigated. Recurrence was defined based on pathogen identity, site of infection and time frame, and not restricted to homologous pathogens.
Results |
We identified 8672 patients with first-time bacteraemia, of whom 1003 (12%) had a recurrence within 1year. The proportion of mono-microbial bacteraemia was similar for first (86%) and recurrent episodes (84%). An unknown focus was common in both episodes (22.7 and 29.1%, respectively). Independent predictors of a recurrence (incidence rate ratio, 95% confidence interval) included health care-associated (2.4; 1.9–3.0) and nosocomial bacteraemia (2.1; 1.8–2.6), poly-microbial Gram-positive bacteraemia (2.7; 1.6–4.6), and fungaemia (2.2; 1.4–3.5), a Charlson co-morbidity index score of 1–2 (1.7; 1.4–2.1), inappropriate empirical antimicrobial chemotherapy (1.3; 1.1–1.5), a gastro-intestinal tract focus (2.3; 1.7–3.0), a liver/biliary tract focus (2.7; 2.0–3.6), an iv-catheter focus (2.0; 1.4–2.8), endocarditis (2.7; 1.6–4.3), and an unknown focus (1.9; 1.5–2.3).
Conclusions |
This study showed recurrent bacteraemia to be common and the following risk factors were identified: a health care-associated or nosocomial origin, poly-microbial or fungal aetiology, a focus within the abdomen, endocardium, iv-catheter-related or unknown, a Charlson co-morbidity index score of >1 and inappropriate empirical antimicrobial chemotherapy.
Le texte complet de cet article est disponible en PDF.Keywords : Bacteraemia, Epidemiology, Recurrence, Outcome
Plan
Vol 60 - N° 3
P. 191-199 - mars 2010 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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