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J Infect. 2008 Jan;56(1):27-34. Epub 2007 Nov 19.

Bloodstream infections in adults: importance of healthcare-associated infections.

Author information

1
Critical Care Center, Hospital Sabadell, Institut Universitari Parc Taulí, 08208 Sabadell, Spain. jvalles@cspt.es

Abstract

OBJECTIVE:

The objective of this study was to evaluate the characteristics of bloodstream infections occurring among outpatients having recent contact with the health care system compared to hospital and community-acquired infections.

METHODS:

Prospective observational cohort study of adult patients with bloodstream infections at three teaching hospitals. Bloodstream infection was defined as hospital-acquired if the first positive blood culture was performed more than 48 h after admission. Other bloodstream infections were classified as healthcare-associated or community-acquired.

RESULTS:

A total of 1157 episodes of bloodstream infections were studied; 581 (50.2%) were community-acquired, 295 (25.5%) were hospital-acquired, and 281 (24.3%) were health care-associated. Of the 281 health care-associated bloodstream infections, 68 (24%) occurred in patients residing in a nursing home, 104 (37%) in patients receiving intravenous therapy, health care at home, chemotherapy or attending dialysis, and 169 (60%) in patients hospitalized during the 90 days before their bloodstream infection (some patients belonged to more than one risk category). The highest prevalence rate of MRSA infections occurred in healthcare-associated infections (5%) (p<0.001). A significantly higher mortality rate was seen in the group with healthcare-associated infections (27.5%) than in community-acquired infections (10.4%) (p<0.001).

CONCLUSIONS:

Our results confirm that healthcare-associated bloodstream infections show important differences from community-acquired bloodstream infections and suggest that empirical antibiotic therapy should be similar to hospital-acquired bloodstream infections, taking into account the epidemiologic characteristics of each region.

PMID:
18022242
DOI:
10.1016/j.jinf.2007.10.001
[Indexed for MEDLINE]

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