Analysis on the Etiology and Prognostic Factors of Community-Acquired Bacteremia in a Community-Based Tertiary Hospital.
- Author:
Sang Won PARK
1
;
Ju Won PARK
;
Sun Il LEE
Author Information
1. Department of Internal Medicine, Dankook University College of Medicine, Chungnam, Korea. hswon@chol.com
- Publication Type:Original Article
- Keywords:
Community-acquired bacteremia;
Etiology;
Prognosis
- MeSH:
Anti-Bacterial Agents;
APACHE;
Bacteremia*;
Diagnosis;
Emergency Service, Hospital;
Epidemiology;
Humans;
Intraabdominal Infections;
Male;
Mortality;
Pneumonia;
Prognosis;
Retrospective Studies;
Skin;
Soft Tissue Infections;
Tertiary Care Centers*;
Urinary Tract Infections
- From:
Infection and Chemotherapy
2005;37(5):255-264
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: We conducted this study to describe the epidemiology of community-acquired bacteremia and identify its prognostic factors. MATERIALS AND METHODS: All patients admitted to a community-based tertiary hospital with community-acquired bacteremia from June 2002 to May 2004 were included and analyzed retrospectively. RESULTS: During the study period, clinically significant community-acquired bacteremia occurred in 223 patients with the frequency of 5.3 patients per 1,000 patient-admission. The commonly isolated organisms were E. coli (47.1%), K. pneumoniae (13.0%), S. aureus (8.1%), and S. pneumoniae (4.5 %). The leading source of bacteremia were urinary tract infection (34.5%), intraabdominal infection (33.6%), primary bacteremia (10.3%), and skin & soft tissue infection (8.1%). The overall mortality was 17%. S. aureus (34.8%) and K. pneumoniae (30.4%) were two major organisms of primary bacteremia with high case fatality of 50% and 28.6%, respectively. Univariate analysis showed that the followings were associated with significant increase in mortality: male patient; S. aureus and other streptococci bacteremia; increasing APACHE II score; definite diagnosis after 3 days of admission; inappropriate antibiotics therapy within 24 hours of admission; emergency room; admission to ICU. The independent predictors of mortality were male patient (RR 3.02, P=0.031), increasing APACHE II score (RR 1.12, P=0.011), and admission to ICU (RR 9.73, P<0.001). CONCLUSION: Rapid definite diagnosis and prompt administration of appropriate antibiotics according to the local epidemiologic pattern are the most important controllable factors for the better outcome.
