Bacteraemia in a general hospital, Bilbao, Spain 19942005
Abstract number: r2242
Ezpeleta C., Atutxa I., Busto C., Gomez E., Cabezas V., Alava J.A., Unzaga J., Cisterna R.
Objective: The aim of this study is to assess the features of bacteraemia in the hospital of Basurto in the last 11 years (Jan 1994Sept 2005).
Blood cultures are performed by means of BACTEC 9240. The Infection Control team studies every patient with positive blood cultures. Variables under surveillance are patient's age and sex, underlying illness, predisposing conditions, source of bacteraemia, nosocomial/community acquired, microorganism and antibiotic susceptibility, antimicrobial treatment, complications and outcome. A computer based surveillance system is used.
7051 episodes of bacteraemia were studied during this period. Incidence from 1994 to 2005 between 17.6 and 22.05 cases/1000 discharges. The incidence remained stable at among 19 cases/1000 discharges with two peaks of incidence in 1995 and 2004. Men (57.51%) aged over 70 y (48.14%) accounted the majority of cases. The most frequent underlying illness was neoplasia present in 1644 patients (23.32%). The urinary (26.86%), gastrointestinal (17.23%) and respiratory tract (14.55%) were the most common sources of bacteraemia. Aetiology: Gram 54.73% (range: 49.758.72), Gram+ 42.61% (range: 39.1842.98%) and yeast 2.58% (range: 1.393.93%). E. coli (30.54%), S. aureus 10.71%, S. pneumoniae 9.56%, S. epidermidis 5.95%, P. aeruginosa 3.46% and Salmonella spp. (3.31%) are the most frequent agents of bacteraemia. Susceptibility to antibiotics: Methicillin resistant S. aureus 12.48% (Range 0% 1994 to 21.33% 2004); E. coli resistant to Ciprofloxacin 12.82% (Range 9.7% 1994 to 15.20% 2004), and to Cefotaxime 0.86% (Range 0% 1994 to 3.8% 2004). In 81.4% episodes appropriated antibiotic treatment was started the same day that blood cultures were obtained. Crude mortality until the end of the episode 16.89% (range: 13.821.36%). Nosocomial bacteraemia accounted 29.88% (range: 2638.7%) of cases. Incidence of nosocomial bacteremia ranged between 3.82-7.41/1000 discharges. Nosocomial acquired bacteraemia aetiology: Gram+ 53.22%, Gram- 40.51% and Yeast 6.14%. Coagulase Negative Staphylococci 23.09%, E. coli 17.73%, S. aureus 16.56%, P. aeruginosa 5.66%. Crude mortality until the end of the episode 25.11% (range: 17.030.34%).
Incidence of bacteraemia remained stable in last 11 years with two peaks of incidence in 1995 and 2004. A trend toward a decrease in fungi was observed in community and nosocomial acquired cases. 51.5% of cases of Methicillin Resistant S. aureus bacteraemia were community acquired.
|Session name:||XXIst ISTH Congress|
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