Nosocomial bloodstream infections in the cardiovascular surgery centre, Iasi, Romania
Abstract number: p1005
Mereuta A., Dan M., Colar L., Tinica G., Georgescu G.I.M., Buiuc D.
To analyse the aetiology, the origin, epidemiological features and outcome of nosocomial bloodstream infections (NBSI) in patients that underwent cardiovascular surgery.
A retrospective study of bloodstream infections was conducted between April 2001 and September 2005 in the Cardiovascular Surgery Centre of Iasi.
There were 57 episodes of nosocomial bloodstream infections at 2068 admissions. Bloodstream infections were secondary to an infectious body site (lower respiratory tract, wound, urinary tract) in 35.08% of the episodes, catheter-related in 22.80% and in 42.10% of cases they had an unknown origin. Cell-wall deficient forms (45.61%) were the most prevalent microorganisms (26 strains, out of which 12 reverted to the classical state: 4 gram-positive cocci, 6 gram-positive bacilli, 1 Gram-negative bacilli, 1 anaerobe and 14 were L-stable), followed by Staphylococcus aureus and coagulase-negative staphylococci 12 strains (21.05%), gram-positive bacilli 11 (19.29%), fungi 8 (14.03%), HACEK group, gram-negative bacilli, Enterococcus spp. 3 strains each (5.26%), Streptococcus pneumoniae 2 (3.50%), anaerobes 1 (1.75%). The proportion of polymicrobial episodes was 3.5% (Staphylococcus aureus + Haemophilus paraphrophilus and H. parainfluenzae + Enterococcus faecalis) and fatality was 26.3%.
We found a high proportion of cell wall deficient forms, rarely reported before. This may be due to: blood culture collection under antimicrobial therapy (P = 0.016), especially beta-lactams; more adequate methods for blood culture processing: sucrose enriched media (Hemoline Performance Duo, bioMerieux, France) and acridine orange stain for microscopy of the blood culture.
|Session name:||XXIst ISTH Congress|
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