Document Detail


Bacteraemia in the adult intensive care unit of a teaching hospital in Nottingham, UK, 1985-1996.
MedLine Citation:
PMID:  9758274     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Bacteraemia is an important cause of morbidity and mortality in the intensive care unit. In this study the distribution of organisms causing bacteraemic episodes in patients in the adult intensive care unit of a large teaching hospital was determined. Particular emphasis was placed on the type of organisms isolated from community- and hospital-acquired bacteraemia, the suspected source of infection, the possible risk factors associated with bacteraemia, and outcome. The incidence of bacteraemia and fungaemia increased from 17.7 per 1000 admissions in 1985 to 80.3 in 1996. A total of 315 episodes of bacteraemia and fungaemia were documented over a 12-year period, of which 18% were considered community-acquired and 82% hospital-acquired. Gram-positive and gram-negative bacteria accounted for 46.9% and 31.5% of the episodes, respectively. Polymicrobial infection accounted for 17.8% and fungi for 3.8% of the episodes. Staphylococcus aureus (22.5%), Staphylococcus epidermidis (7.6%), and Streptococcus pneumoniae (7.9%) were the predominant gram-positive bacteria implicated, whereas Escherichia coli (6%), Enterobacter cloacae (7%), Klebsiella aerogenes (3.8%), Pseudomonas aeruginosa (5.1%), and Acinetobacter spp. (3.8%) were the predominant gram-negative bacteria isolated. The two most common sources of infection were the respiratory tract (39.7%) and an intravascular line (24.5%), but in 8.9% of episodes the focus of infection remained unknown. Bacteraemic patients stayed in the unit for a longer period (12 days) than did non-bacteraemic patients (3 days). The overall mortality related to bacteraemia and candidaemia was 44.4%. Surveillance of bacteraemia in the intensive care unit is important in detecting major changes in aetiology, e.g., the increasing incidence of gram-positive bacteraemia, the emergence of methicillin-resistant Staphylococcus aureus in 1995, and the emergence of Enterobacter cloacae. It is of value in determining empirical antimicrobial therapy to treat presumed infection pending a microbiological diagnosis and in directing the development of guidelines for infection prevention, e.g., guidelines for central venous catheter care.
Authors:
M Crowe; P Ispahani; H Humphreys; T Kelley; R Winter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology     Volume:  17     ISSN:  0934-9723     ISO Abbreviation:  Eur. J. Clin. Microbiol. Infect. Dis.     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-11-25     Completed Date:  1998-11-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804297     Medline TA:  Eur J Clin Microbiol Infect Dis     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  377-84     Citation Subset:  IM    
Affiliation:
Division of Microbiology and Infectious Diseases, Queen's Medical Centre, Nottingham, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Bacteremia / epidemiology*,  microbiology*,  mortality
Community-Acquired Infections
Cross Infection
Drug Resistance, Microbial
Female
Fungemia / epidemiology,  microbiology,  mortality
Gram-Negative Bacteria / drug effects,  isolation & purification
Gram-Negative Bacterial Infections / epidemiology*
Gram-Positive Bacteria / drug effects,  isolation & purification
Gram-Positive Bacterial Infections / epidemiology*
Great Britain / epidemiology
Hospitals, Teaching*
Humans
Incidence
Intensive Care Units*
Male
Microbial Sensitivity Tests
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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