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Diagn Microbiol Infect Dis. 2001 Sep-Oct;41(1-2):15-22.

Four-year prospective evaluation of community-acquired bacteremia: epidemiology, microbiology, and patient outcome.

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1
Department of Internal Medicine, Division of Infectious Diseases, and Department of Control and Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.

Abstract

The objectives of this study were to (1) describe the epidemiology and microbiology of community-acquired bacteremia; (2) determine the crude mortality associated with such infections; and (3) identify independent predictors of mortality. All patients with clinically significant community-acquired bacteremia admitted to a university-affiliated Veterans Affairs medical center from January 1994 through December 1997 were evaluated. During the study period, 387 bacteremic episodes occurred in 334 patients. Staphylococcus aureus, Escherichia coli, and coagulase-negative staphylococci were the most commonly isolated organisms; the most frequent sources were the urinary tract and intravascular catheters. Approximately 14% of patients died. Patient characteristics independently associated with increased mortality included shock (OR 3.7, p = 0.02) and renal failure (OR 4.0, p = 0.003). The risk of death was also higher in those whose source was pneumonia (OR 6.3, p = 0.03) or an intra-abdominal site (OR 10.7, p = 0.02), or if multiple sources were identified (OR 13.4, p = 0.003). Community-acquired bacteremia is often device-related and may be preventable. Strategies that have been successful in preventing nosocomial device-related bacteremia should be adapted to the outpatient setting.

PMID:
11687309
DOI:
10.1016/s0732-8893(01)00284-x
[Indexed for MEDLINE]

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