Persistent bacteremia and fungemia-risk factors and clinical significance.
- Author:
Won Suk CHOI
1
;
Yu Bin SEO
;
Yu Mi JO
;
Jeong Yeon KIM
;
Sae Yoon KEE
;
Hye Won JEONG
;
Dae Won PARK
;
Jang Wook SOHN
;
Hee Jin CHOENG
;
Min Ja KIM
;
Woo Joo KIM
Author Information
1. Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. wjkim@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Bacteremia;
Fungemia;
Risk factors;
Prognosis
- MeSH:
Abscess;
Anti-Bacterial Agents;
Bacteremia*;
Candida;
Case-Control Studies;
Central Venous Catheters;
Cross Infection;
Follow-Up Studies;
Fungemia;
Humans;
Korea;
Length of Stay;
Medical Records;
Mortality;
Prognosis;
Retrospective Studies;
Risk Factors
- From:Korean Journal of Medicine
2007;72(6):647-657
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUDN: Persistent bloodstream infection is known to cause high mortality and a prolonged hospital stay. We performed a study examining risk factors and the clinical significance of persistent bacteremia and fungemia. METHODS: This was a case-controlled study. Medical records of patients with bacteremia or fungemia in one university hospital in Korea from May 1999 to February 2005 were retrospectively reviewed. Patients with persistent positive blood cultures regardless of antibiotic treatment for more than three days were assigned to the persistent group. Patients with positive blood cultures only on the same calendar days with the persistent group but negative on follow-up were assigned to the short-term group. RESULTS: A total of 64 patients were enrolled in the persistent group, and 146 patients in the short-term group among 1,737 patients with positive blood cultures. The persistent group was associated with previous antibiotic usage within 1 month (p=0.033), nosocomial infection (p=0.026), having an abscess (p=0.008), and infection by mixed organisms (p=0.001), independently. Candida sp. as a causative organism, treatment with inappropriate empirical antibiotics, having a central venous catheter, or ICU care at the time of blood culture was higher in the persistent group as well. The persistent group had a prolonged number of hospital-days (p=0.010), but there was no difference in mortality between the two groups. CONCLUSIONS: Patients with a persistent bloodstream infection should be assessed about previous antibiotic usage within 1 month, nosocomial infection, having an abscess, infection by mixed organisms, Candida sp. as a causative organism, treatment with inappropriate empirical antibiotics, having central venous catheter, or ICU care at the time of blood culture.
