TY - JOUR. T1 - Risk factors for and clinical implications of mixed Candida/bacterial bloodstream infections. AU - Kim, S. H.. AU - Yoon, Y. K.. AU - Kim, M. J.. AU - Sohn, J. W.. PY - 2013/1. Y1 - 2013/1. N2 - Mixed Candida/bacterial bloodstream infections (BSIs) have been reported to occur in more than 23% of all episodes of candidaemia. However, the clinical implications of mixed Candida/bacterial BSIs are not well known. We performed a retrospective case-control study of all consecutive patients with candidaemia over a 5-year period to determine the risk factors for and clinical outcomes of mixed Candida/bacterial BSIs (cases) compared with monomicrobial candidaemia (controls). Thirty-seven (29%) out of 126 patients with candidaemia met the criteria for cases. Coagulase-negative staphylococci were the predominant bacteria (23%) in cases. In multivariate analysis, duration of previous hospital stay ≥7weeks (odds ratio (OR), 2.86; 95% confidence interval (CI), 1.09-7.53), prior antibiotic ...
This MyHospitals web update presents information [email protected] Staphylococcus aureus bloodstream infections for 677 Australian public hospitals and around 70 private hospitals in [email protected]
Report Publication; Hospital Performance: Healthcare-associated Staphylococcus aureus bloodstream infections in 2015-16, In Focus ; Released 2017; Golden Staph
Background. Staphylococcus aureus bloodstream infection (SABSI) arising from a urinary tract source (UTS) is poorly understood. Methods. We conducted a retrospective analysis in 3 major teaching hospitals in Spain of prospectively collected data of hospitalized patients with SABSI. SABSI-UTS was diagnosed in patients with urinary tract symptoms and/or signs, no evidence of an extra-urinary source of infection, and a urinary S. aureus count of ,= 10(5) cfu/mL. Susceptibility of S. aureus strains and patient mortality were compared between SABSI from UTS (SABSI-UTS) and other sources (SABSI-other). Results. Of 4181 episodes of SABSI, we identified 132 (3.16%) cases of SABSI-UTS that occurred predominantly in patients who were male, had high Charlson comorbidity scores, were dependent for daily life activities, and who had undergone urinary catheterization and/or urinary manipulation before the infection. SABSI-UTS was more often caused by MRSA strains compared with SABSI-other (40.9% vs 17.5%; P , ...
Bacteremia is the presence of bacteria in the bloodstream that are alive and capable of reproducing. It is a type of bloodstream infection.[9] Bacteremia is defined as either a primary or secondary process. In primary bacteremia, bacteria have been directly introduced into the bloodstream.[10] Injection drug use may lead to primary bacteremia. In the hospital setting, use of blood vessel catheters contaminated with bacteria may also lead to primary bacteremia.[11] Secondary bacteremia occurs when bacteria have entered the body at another site, such as the cuts in the skin, or the mucous membranes of the lungs (respiratory tract), mouth or intestines (gastrointestinal tract), bladder (urinary tract), or genitals.[12] Bacteria that have infected the body at these sites may then spread into the lymphatic system and gain access to the bloodstream, where further spread can occur.[13]. Bacteremia may also be defined by the timing of bacteria presence in the bloodstream: transient, intermittent, or ...
BACKGROUND:Staphylococcus aureus persistent bacteraemia is only vaguely defined and the effect of different durations of bacteraemia on mortality is not well established. Our primary aim was to analyse mortality according to duration of bacteraemia and to derive a clinically relevant definition for persistent bacteraemia. METHODS:We did a secondary analysis of a prospective observational cohort study at 17 European centres (nine in the UK, six in Spain, and two in Germany), with recruitment between Jan 1, 2013, and April 30, 2015. Adult patients who were consecutively hospitalised with monomicrobial S aureus bacteraemia were included. Patients were excluded if no follow-up blood culture was taken, if the first follow-up blood-culture was after 7 days, or if active antibiotic therapy was started more than 3 days after first blood culture. The primary outcome was 90-day mortality. Univariable and time-dependent multivariable Cox regression analysis were used to assess predictors of mortality. Duration of
BACKGROUND Pseudomonas aeruginosa bacteremia (PAB) is associated with high mortality and morbidity rates, but the outcome for patients with PAB has not been recently well evaluated. METHODS Between 1997 and 1999, all episodes of PAB at the Hôtel-Dieu de France University Hospital, Lebanon, were analyzed to evaluate the outcome for patients with PAB. RESULTS Fifty-five episodes of PAB in 53 patients (26 episodes in men and 29 in women) were analyzed. The mean age of the patients in the cohort was 60.7 years (range: 18-89 years). The mean time between the onset of hospitalization and the first episode of PAB was 21 days (range: 0-77 days). Most of the tested isolates showed favorable in vitro susceptibility to ceftazidime (85%), amikacin (77%) and imipenem (67%). The overall in-hospital cumulative survival was 89% at one week and 49% at 2 months. Among the variables analyzed, four were statistically associated with a higher mortality rate: prior use of antimicrobials (85% vs 54%), use of systemic
Staphylococcus aureus is one of the leading causes of bloodstream infection, and these infections still have a high mortality. In certain clinical situations and for the planning of future prophylactic precautions, it is important to identify patients at risk of S. aureus bloodstream infection. Nearly all patients with S. aureus bloodstream...
TY - JOUR. T1 - Performance of processes of care and outcomes in patients with Staphylococcus aureus bacteremia. AU - Rosa, Rossana. AU - Wawrzyniak, Andrew. AU - Sfeir, Maroun. AU - Smith, Laura. AU - Abbo, Lilian M.. PY - 2016/1/1. Y1 - 2016/1/1. N2 - BACKGROUND: Staphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality in hospitalized adults. OBJECTIVE: We aimed to identify current practice patterns in the management of SAB, and to evaluate their association with clinical outcomes. DESIGN: Retrospective cohort study. SETTING: A 1558-bed tertiary care teaching hospital. PATIENTS: Adult patients hospitalized between January 1, 2012 through April 30, 2013, who had at least 1 positive blood culture with S aureus. INTERVENTION: None MEASUREMENTS: Electronic medical records were reviewed and the processes of care in the management of SAB were identified. The main outcome was clinical failure, defined as a composite endpoint of in-hospital mortality and persistent ...
The incidence of Pseudomonas aeruginosa bacteraemia (PAB) has remained stable over the last few decades.1-3 Although it is still primarily a nososcomial infection, the number of cases of community-acquired bacteraemia caused by this organism has increased, notably affecting patients with AIDS4,5 and neutropenic patients treated for neoplastic disease who received outpatient management.6 Predisposing conditions for PAB include compromised immunity, neutropenia, intensive care, surgical procedures, central venous and urinary catheters and previous cephalosporin therapy.1,3-5,6 Common factors predictive of a fatal outcome reported in the literature are septic shock, neutropenia, immunocompromised state, severe underlying disease, and in the elderly pneumonia, septic metastases, previous therapy and inappropriate choice of antimicrobial drugs for definitive treatment.1,6,7. P. aeruginosa has also emerged as an important bacteraemic pathogen in immunocompromised children,6,8,9 including ...
The incidence of Pseudomonas aeruginosa bacteraemia (PAB) has remained stable over the last few decades.1-3 Although it is still primarily a nososcomial infection, the number of cases of community-acquired bacteraemia caused by this organism has increased, notably affecting patients with AIDS4,5 and neutropenic patients treated for neoplastic disease who received outpatient management.6 Predisposing conditions for PAB include compromised immunity, neutropenia, intensive care, surgical procedures, central venous and urinary catheters and previous cephalosporin therapy.1,3-5,6 Common factors predictive of a fatal outcome reported in the literature are septic shock, neutropenia, immunocompromised state, severe underlying disease, and in the elderly pneumonia, septic metastases, previous therapy and inappropriate choice of antimicrobial drugs for definitive treatment.1,6,7. P. aeruginosa has also emerged as an important bacteraemic pathogen in immunocompromised children,6,8,9 including ...
To assess whether methicillin resistance is a microbial characteristic associated with deleterious clinical outcome, we performed a cohort study on 908 consecutive episodes of Staphylococcus aureus bacteremia and a case-control study involving 163 pairs of patients matched for preexisting comorbidities, prognosis of the underlying disease, length of hospitalization, and age. Of 908 bacteremic episodes, 225 (24.8%) were due to methicillin-resistant S. aureus (MRSA). Multivariate analysis did not reveal that methicillin resistance was an independent predictor for mortality when shock, source of bacteremia, presence of an ultimately or rapidly fatal underlying disease, acquisition of the infection in an intensive care unit (ICU), inappropriate empirical therapy, female sex, and age were taken into account. Nonetheless, methicillin resistance was an independent predictor for shock. The case-control study could not confirm that shock was linked to MRSA when prior antimicrobial therapy, inappropriate ...
All bacteraemic cases, from August 2006 to September 2007 were identified by reviewing all positive blood culture results from the microbiology department of our hospital. One thousand three hundred and sixty six cases were detected in 1336 patients. The rate of true bacteremia which was 13.1 and 10.7% of cultures were contaminated. Of the 1366 episodes of bloodstream infection, 55.3% were community-acquired and 44.7% were health-care associated. Gram-positive bacteria prevailed (58.5%), followed by gram negative bacilli (38.5%). Polymicrobial bacteremia was detected in 2.2% of cases. Coagulase-negative staphylococci (CoNS) were the leading cause (550/1366 = 40.3%), whilst enterococci,Staphylococcus aureus and Streptococci represented 8, 6.4 and 3.8% respectively. Pseudomonas aeruginosa was the commonest gram-negative isolate (155/1366 = 11.3%), followed by Escherichia coli (8.2%) and Acinetobactersp. (7.3%). Fungi were isolated in
Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia remains a condition associated with considerable morbidity and mortality worldwide. It is a common but little-studied problem outside of Europe and North America. A single-centre retrospective case series profiling all patients with community onset-MSSA bacteraemia presenting between March 2005 and February 2006 to a tertiary acute-care university hospital in Singapore. In addition to epidemiological and clinical data collection, risk factors for complicated bacteremia and attributable mortality were analysed. A total of 100 patients met the case definition. Patients were more likely to be male (65%) and below 65 years of age (69%). Seventeen patients were intravenous drug abusers, while 38 had diabetes mellitus. There were 18 cases of endocarditis, with 11 occurring in intravenous buprenorphine abusers. Attributable mortality was 11%, and 46% of patients developed complicated bacteremia. On multivariate analysis, age | 65 years and
BACKGROUND: Staphylococcus aureus bacteraemia is a common and serious infection, with an associated mortality of ~25%. Once in the blood, S. aureus can disseminate to infect almost any organ, but bones, joints and heart valves are most frequently affected. Despite the infections severity, the evidence guiding optimal antibiotic therapy is weak: fewer than 1,500 patients have been included in 16 randomised controlled trials investigating S. aureus bacteraemia treatment. It is uncertain which antibiotics are most effective, their route of administration and duration, and whether antibiotic combinations are better than single agents. We hypothesise that adjunctive rifampicin, given in combination with a standard first-line antibiotic, will enhance killing of S. aureus early in the treatment course, sterilise infected foci and blood faster, and thereby reduce the risk of dissemination, metastatic infection and death. Our aim is to determine whether adjunctive rifampicin reduces all-cause mortality within
|jats:title|Abstract|/jats:title||jats:sec||jats:title|Background|/jats:title||jats:p|Antibiotic resistance poses a threat to public health and a burden to healthcare systems. |jats:italic|Escherichia coli|/jats:italic| causes more bacteraemia cases in England than any other bacterial species, these infections, in part due to their high incidence, also pose a significant antibiotic resistance burden. The main aim of this study was to estimate the impact of |jats:italic|E. coli|/jats:italic| bacteraemia on patient in-hospital mortality and length of stay. Secondarily, this study also aimed to estimate the effect of antibiotic resistance on these outcomes.|/jats:p||/jats:sec||jats:sec||jats:title|Methods and Findings|/jats:title||jats:p|Case patients were adult |jats:italic|E. coli|/jats:italic| bacteraemia patients infected between July 2011 and June 2012, as reported in an English national mandatory surveillance database, with susceptibility data taken from a national laboratory surveillance database.
The factors related to the occurrence of bacteraemia following urinary tract manipulation were studied in a large community hospital. During a 3-year period, forty-six of 326 episodes of hospital-acquired bacteraemia were associated with urinary tract manipulation. All thirty of forty-six cases felt to be definitely related to urinary tract manipulation (other obvious sources of bacteraemia being absent) had pre-existing urinary tract disease, especially of an obstructive type; only one in this group died from sepsis. The remaining sixteen patients had other possible sources of bacteraemia besides urinary tract manipulation and had disorders associated with defects in host defences; twelve (75%) in this group died from overwhelming sepsis. Thus, if bacteraemia occurs in a patient having had urinary tract manipulation but without any underlying urinary tract abnormality or impairment in host defences, its source should be searched for in other areas of the body.. ...
There were 1632 admissions with 45 nosocomial Gram-negative bacteremias in 44 patients. Infection rates of 28.2/1000 admissions and 12.1/10 000 patient-days remained stable over 5 years. The mean patient age was 55.3 years (range 17-86 years); 27.3% of patients were female, and 72.8% were male. The majority (95.6%) of bloodstream infections were monomicrobial, with only one episode of polymicrobial bacteremia. Common admitting diagnoses included respiratory failure, solid organ transplant, post-surgery, and multi-trauma. Seven bacterial species were identified; Pseudomonas aeruginosa and Enterobacter spp. were most common. Sources of bacteremia included pneumonia (48.9%), followed by central venous catheterization (22.2%). The mean time from admission to hospital to development of bacteremia was 32.9 days (95% confidence interval [CI] 0-100.9), and time from admission to the ICU was slightly less at 26.0 days (95% CI 0-90.1). Antimicrobial susceptibilities were highest for imipenem, gentamicin, ...
The P. mirabilis is isolated from 1% to 3% of all BSIs (Laupland et al. 2007; Sohn et al. 2011). Our study confirms these data. We also observed Proteus spp. BSIs in 2.5% of all BSIs investigated. Among Enterobacterales, P. mirabilis is the fourth Gram-negative bacteria species after E. coli, Klebsiella pneumoniae, and Enterobacter spp. isolated from hospital-acquired BSIs (Sohn et al. 2011). BSIs are well-known cause of high mortality. We found that mortality rate of P. mirabilis BSIs was 28.9%. It is similar value to that obtained by Endimiani et al. (2005). They found that mortality rate attributable to P. mirabilis BSIs was 33.0%.. Laupland et al. (2014) showed that most cases of P. mirabilis bacteremia (18; 72.0%) have no documented sources and were recognized as primary bacteremia. In another seven (28.0%) cases, the urinary tract was confirmed to be the source of bacteremia. The opposite results were reported by Sohn et al. (2011). They detected primary bacteremia caused by Proteus spp. ...
Methicillin-resistant Staphylococcus aureus (MRSA) infection is still a major global healthcare problem. Of concern is S. aureus bacteremia, which exhibits high rates of morbidity and mortality and can cause metastatic or complicated infections such as infective endocarditis or sepsis. MRSA is responsible for most global S. aureus bacteremia cases, and compared with methicillin-sensitive S. aureus, MRSA infection is associated with poorer clinical outcomes. S. aureus virulence is affected by the unique combination of toxin and immune-modulatory gene products, which may differ by geographic location and healthcare- or community-associated acquisition. Management of S. aureus bacteremia involves timely identification of the infecting strain and source of infection, proper choice of antibiotic treatment, and robust prevention strategies. Resistance and nonsusceptibility to first-line antimicrobials combined with a lack of equally effective alternatives complicates MRSA bacteremia treatment. This review
Evaluate the safety of ceftaroline fosamil in adult Subjects (≥ 18 years of age) with Staphylococcus aureus Bacteremia or with MRSA Bacteremia persisting after at least 72 hours of vancomycin and/or daptomycin treatment [ Time Frame: 60 days following completion of antibacterial therapy and discharge from the hospital, anticipated between 74 to 119 days ...
By Stan Deresinski, MD, FACP, FIDSA Clinical Professor of Medicine, Stanford University Dr. Deresinski reports no financial relationships relevant to this field of study. SYNOPSIS: The addition of rifampin to standard therapy failed to provide significant benefit to patients with bacteremia due to Staphylococcus aureus. SOURCE: Thwaites GE, Scarborough M, Szubert A, et al; United Kingdom Clinical Infection Research Group (UKCIRG). Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): A multicentre, randomised, double-blind, placebo-controlled trial. Lancet 2017 Dec 14. pii: S0140-6736(17)32456-X. doi: 10.1016/S0140-6736(17)32456-X. [Epub ahead of . . .
S. aureus bacteremia (SAB) is a common condition with high rates of morbidity and mortality. Current methods used to diagnose SAB take at least a day, and often longer. Patients with suspected bacteremia must therefore be empirically treated, often unnecessarily, while assay results are pending. In this proof-of-concept study, we describe an inexpensive assay that detects SAB via the detection of micrococcal nuclease (an enzyme secreted by S. aureus) in patient plasma samples in less than three hours. In total, 17 patient plasma samples from culture-confirmed S. aureus bacteremic individuals were tested. 16 of these yielded greater nuclease assay signals than samples from uninfected controls or individuals with non-S. aureus bacteremia. These results suggest that a nuclease-detecting assay may enable the rapid and inexpensive diagnosis of SAB, which is expected to substantially reduce the mortality and morbidity that result from this condition.
Staphylococcus aureus bacteraemia (SAB) is commonly complicated by metastatic infection or relapse after treatment. Objectives. The study aim was to determine the role of bacterial, host, and management factors in development of complicated SAB. Methods. A prospectively-conducted observational study gathered data on predisposition, management and outcome of 100 consecutive SAB cases. Antibiotic susceptibilities and genetic lineage of bacterial isolates were determined. Further clinical and microbiological data were gathered on two retrospective series from 1999-2000 (n = 57) and 2004 (n = 116). Results. In the prospective cases, 27% met our definition of complicated disease. Expressed as RR and 95% CI, complicated disease was associated with diabetes (1.58, 1.00-2.48), injecting-drug use (5.48, 0.88-33.49), community-onset of symptoms (1.4, 1.02-1.92), and symptom duration ,/=48 hours prior to starting effective antibiotic therapy (2.10, 1.22-3.61). Uncomplicated disease was associated with the ...
In 2014-15, 1,490 cases of hospital-associated Staphylococcus aureus bacteraemia (SAB) were reported in Australian public hospitals. The national rate of SAB in public hospitals was 0.77 cases per 10,000 days of patient care, and all states and territories had rates below the national benchmark of 2.0 cases per 10,000 days of patient care. Between 2010-11 and 2014-15, rates of SAB decreased from 1.10 cases to 0.77 cases per 10,000 days of patient care.. ...
Clinical questions: What are the trends in patient outcome for Staphylococcus aureus bacteremia (SAB)? Does the use of evidence-based care processes decrease mo
By Achim J. Kaasch, Gavin Barlow, Jonathan D. Edgeworth, Vance G. Fowler, Martin Hellmich, Susan Hopkins, Winfried V. Kern, Martin J. Llewelyn, Siegbert Rieg, Jesús Rodriguez-Baño, Matthew Scarborough, Harald Seifert, Alex Soriano, Robert Tilley, M. Estée Tőrők, Verena Weiß, A.Peter R. Wilson and Guy E. Thwaites ...
Background: Staphylococcus aureus is one of the causes of both community and healthcare-associated bacteremia. The attributable mortality of S. aureus bacteremia (SAB) is still higher and predictors for mortality and clinical outcomes of this condition are need to be clarified. In this prospective observational study, we aimed to examine the predictive factors for mortality in patients with SAB in eight Turkish tertiary care hospitals. ...
What drug can cause Streptococcal Bacteraemia as their side effect? Check drug and medication side effect reports associated with Streptococcal Bacteraemia
It is generally well established that dental cares cause bacteremia, and that most are due to streptococcal strains [1,2]. It is, consequently, reasonable to think that prescribing antibiotics before dental cares decreases the incidence of such bacteremia. Globally, the discordant results between the different kinds of studies analyzed in the paper by Cahill et al. [1] are clearly insufficient to conclude that antibiotic prophylaxis prevents bacteremia due to streptococci. In our view, this observation can be explained by the fact that dental care is not the only cause of streptococcal bacteremia. Indeed, such bacteremia are extremely common, and it has been demonstrated that they can occur after chewing and after brushing in patients with periodontitis (cumulatively in 25% and 20% of cases, respectively) [2]. It is, therefore, fairly unlikely that bacteremias due to dental cares are more responsible for endocarditis than other kinds of bacteremias. In practice, this implies that the only ...
BACKGROUND: Staphylococcus aureus is a common cause of bacteremia, yet the epidemiology, and predictors of poor outcome remain inadequately defined in childhood. METHODS: ISAIAH is a prospective, cross-sectional study of S. aureus bacteremia (SAB), in children hospitalized in Australia and New Zealand, over 24-months (2017-2018). RESULTS: Overall, 552 SABs were identified, (incidence 4.4/100,000/yr [95% confidence interval (CI) 2.2-8.8]), with methicillin-susceptible (84%), community onset (78%) infection predominating. Indigenous children (8.1/100,000/yr [CI 4.8-14.4]), those from lower-socioeconomic areas (5.5/100,000/yr [CI 2.8-10.2]) and neonates (6.6/100,000/yr (CI 3.4-11.7) were over-represented. Although 90-day mortality was infrequent, one-third experienced the composite of: length of stay ,30 days (26%), ICU admission (20%), relapse (4%), or death (3%).Predictors of mortality included prematurity (aOR 16.8 [CI 1.6-296.9]), multifocal infection (aOR 22.6 [CI 1.4-498.5]), necrotizing ...
An improvement resource to help health and social care economies reduce the number of Gram-negative bloodstream infections (BSIs) with an initial focus on Escherichia coli (E.coli).
article{1887963, author = {Reunes, Sofie and Rombaut, Vicky and Vogelaers, Dirk and Brusselaers, Nele and Lizy, Christelle and Cankurtaran, Mustafa and Labeau, Sonia and Petrovic, Mirko and Blot, Stijn}, issn = {0953-6205}, journal = {EUROPEAN JOURNAL OF INTERNAL MEDICINE}, keyword = {ANTIMICROBIAL THERAPY,HOSPITAL MORTALITY,MULTIDRUG-RESISTANCE,OLD PATIENTS,ATTRIBUTABLE MORTALITY,Bloodstream infection,Elderly,Risk factors,Geriatric patient,Mortality,CRITICALLY-ILL PATIENTS,CARE-UNIT PATIENTS,INTENSIVE-CARE,PSEUDOMONAS-AERUGINOSA,BACTEREMIA}, language = {eng}, number = {5}, pages = {e39--e44}, title = {Risk factors and mortality for nosocomial bloodstream infections in elderly patients}, url = {http://dx.doi.org/10.1016/j.ejim.2011.02.004}, volume = {22}, year = {2011 ...
The results presented above indicate that in our study population IL-6 levels, but not IL-1 and TNF levels, are significantly higher in the children with occult bacteremia than in those with apparent viral infection. Interleukin 6 seems more advantageous in predicting bacteremia than WBC, and equivalent to the ANC. This observation is supported by the equality of the receiver-operator characteristic curves and areas under the curves for IL-6 and ANC and the lower curve and lesser area for WBC as shown Fig 1. However, there is overlap of the IL-6 levels between the bacteremic and nonbacteremic groups. This overlap detracts from the utility of IL-6 in distinguishing bacteremic from nonbacteremic patients and results in the modest sensitivity and specificity presented in Table 3.. From the traditional clinical and laboratory data evaluated in this study, the ANC was found to be the best means of predicting occult bacteremia at the time of the initial visit. The sensitivity and specificity for the ...
The outcome of patients with bacteraemia is influenced by the initial selection of adequate antimicrobial therapy. The objective of our study was to clarify the influence of different crude data correction methods on a) microbial spectrum and ranking of pathogens, and b) cumulative antimicrobial susceptibility pattern of blood culture isolates obtained from patients from intensive care units (ICUs) using a computer based tool, MONI. Analysis of 13 ICUs over a period of 7 years yielded 1427 microorganisms from positive results. Three different data correction methods were applied. Raw data method (RDM): Data without further correction, including all positive blood culture results. Duplicate-free method (DFM): Correction of raw data for consecutive patients results yielding same microorganism with similar antibiogram within a two-week period. Contaminant-free method (CFM): Bacteraemia caused by possible contaminants was only assumed as true bloodstream infection, if an organism of the same species was
Bacteremia and infective endocarditis (IE) are important causes of morbidity and mortality associated with Staphylococcus aureus infections. Increasing exposure to healthcare, invasive procedures, and prosthetic implants has been associated with a rising incidence of S. aureus bacteremia (SAB) and IE since the late twentieth century. S. aureus is now the most common cause of bacteremia and IE in industrialized nations worldwide and is associated with excess mortality when compared to other pathogens. Central tenets of management include identification of complicated bacteremia, eradicating foci of infection, and, for many, prolonged antimicrobial therapy. Evolving multidrug resistance and limited therapeutic options highlight the many unanswered clinical questions and urgent need for further high-quality clinical research ...
Nosocomial bacteremia is associated with a poor prognosis. Early adequate therapy has been shown to improve outcome. Consequently, rapid detection of a beginning sepsis is therefore of the utmost importance. This historical cohort study was designed to evaluate if different patterns can be observed in either C-reactive protein (CRP) and white blood cell count (WCC) between Gram positive bacteremia (GPB) vs. Gram negative bacteremia (GNB), and to assess the potential benefit of serial measurements of both biomarkers in terms of early antimicrobial therapy initiation. A historical study (2003-2004) was conducted, including all adult intensive care unit patients with a nosocomial bacteremia. CRP and WCC count measurements were recorded daily from two days prior (d-2) until one day after onset of bacteremia (d+1). Delta (Δ) CRP and Δ WCC levels from the level at d-2 onward were calculated. CRP levels and WCC counts were substantially higher in patients with GNB. Logistic regression analysis demonstrated
In Australia, MRSA bacteraemias cause up to 40 per cent of all healthcare-acquired Staphylococcus aureus (S. aureus) bacteraemia [9]. MRSA bacteraemias are associated with increased risk of mortality [10] and contribute a considerable cost to the healthcare system due to the need for prolonged hospital stays, re-admissions and additional diagnostic tests and treatment [11]. National reporting of healthcare acquired S. aureus bacteraemias, including those caused by MRSA, was introduced in Australia in 2008. MRSA bacteraemia incidences and rates also are a key performance indicator for jurisdictions under the National Healthcare Agreement [12]. This section reports inpatient and non-inpatient healthcare-acquired MRSA bacteraemias data. ...
Early administration of appropriate antimicrobials has been correlated with a better prognosis in patients with bacteremia, but the optimum timing of early antibiotic administration as one of the resuscitation strategies for severe bacterial infections remains unclear. In a retrospective cohort study, adults with community-onset bacteremia at the emergency department (ED) were analyzed. Effects of different cutoffs of time to appropriate antibiotic (TtAa) administration after arrival at the ED on 28-day mortality were examined, after adjustment for independent predictors of mortality identified by multivariate regression analysis. Among 2349 patients, the mean (interquartile range) TtAa was 2.0 (|1 to 12) hours. All selected cutoffs of TtAa, ranging from 1 to 96 hours, were significantly associated with 28-day mortality (adjusted odds ratio (AOR), 0.54-0.65, all P | 0.001), after adjustment of the following prognostic factors: fatal comorbidities (McCabe classification), critical illness (Pitt
Bacteremia. How long to treat? It depends in part the underlying infection, but with the exception of S. aureus, the data suggest that shorter (5-7 days) are no worse than longer courses of antibiotics for bacteremia from a variety of sources. Mostly we treat some multiple of 7 since we have 7 days in the week.. Twenty-four eligible trials were identified, including one trial focusing exclusively on bacteremia, zero in catheter related bloodstream infection, three in intra-abdominal infection, six in pyelonephritis, 13 in pneumonia and one in skin and soft tissue infection. Thirteen studies reported on 227 patients with bacteremia allocated to shorter or longer durations of treatment. Outcome data were available for 155 bacteremic patients: neonatal bacteremia (n=66), intra- abdominal infection (40), pyelonephritis (9), and pneumonia (40). Among bacteremic patients receiving shorter (5-7 days) versus longer (7-21 days) antibiotic therapy, no significant difference was detected with respect ...
The aim of this study was to assess the sensitivity and specificity of catheter-drawn and peripheral blood cultures. Paired blood culture samples collected over a 44-month period from a 280 bed Brisbane metropolitan hospital were analysed, using standard clinical and microbiological criteria, to determine whether blood culture isolates represented true bacteraemias or contamination. Catheter-collected cultures had a specificity of 85% compared with 97% for peripheral cultures. In only two instances (0.2%) was the diagnosis of clinically significant bacteraemia made on the basis of catheter culture alone. This study concluded that cathetercollected samples are not a good test for true bacteraemia, and that peripheral cultures are more reliable when the results of the paired cultures are discordant.. ...
1) The presence of bacteria in the blood. Bacteremia is diagnosed by growing organisms from a blood sample and treatment is with antibiotics. See: Infections Associated with Lymphedema (2) The presence of live bacteria in the bloodstream. Bacteremia is analogous to viremia (the presence of a virus in the blood) and parasitemia (the presence of a parasite in the blood). Bacteremia, viremia and parasitemia are all forms of sepsis (bloodstream infection). The term bacteremia was compounded from bacteria and -emia (in the blood). Also called bacillemia. ...
Background: Improvements in central line placement practices have decreased the rates of central line associated bloodstream infections (CLABSI). Further progress in reducing infection may rest on processes related to line maintenance and care. Methods: We evaluated the effect of an alcohol disinfection cap on rates of nosocomial bacteremia. The plastic caps fit on the exposed ends of IV needless access devices and contain a pad saturated with 70% isopropyl alcohol for disinfection: we alternated between similar products by two different manufacturers. The caps were placed on all ports of peripheral and central lines when not in use. Four hospital units with higher central line use were chosen for this yearlong intervention (an intensive care unit, a step down unit, and two medical surgical units). Nosocomial bloodstream infections and CLABSI were monitored for these units, along with four units not part of this intervention (to control for changes over time). The year prior to implementation ...
Bacteremia is a bacterial infection that has spread to the bloodstream. This is serious because it can cause a lot of harm to the body. It can spread to other organs, including the kidneys, brain, and lungs. Bacteremia that spreads and harms other parts of the body is called sepsis. You will have lab tests and imaging tests. The lab tests will include blood cultures to check for bacteremia. They will help show the type of bacteria that you have. You will likely be given antibiotics before the results of the blood cultures are known. ...
The probability of at least 1 microorganism being isolated at 6 hours was 13-fold higher with the SeptiFast test than with blood cultures (relative risk, 13.5; 95% CI, 5.05-36.06). Unlike culture results, SeptiFast test results were not associated with previous antibiotic consumption. The median time to the first positive blood culture result was 17 hours; SeptiFast results were available in 6 hours. SeptiFast detected genetic material from potentially multiresistant microorganisms in patients whose blood cultures showed no growth at all. ...
Staphylococcus aureusis a leading cause of both community- and healthcare-associated bacteremia.S. aureusbacteremia (SAB) is associated with increased morbidity and mortality, even with appropriate therapy.The epidemiology and clinical features of SA
The non-hematologic malignancies included esophageal cancer (2) and bladder cancer (1). Seven patients (54%) were neutropenic (defined as Absolute Neutrophil Count , 1500 cells/uL) with an average duration of 14 days. The median age was 60 years. There was no gender predilection. Seven patients had mucositis at the time of diagnosis either due to chemotherapy or graft versus host disease. One patient had gingivitis with a dental abscess. None of the patients developed infective endocarditis. Most patients were on empiric antimicrobial therapy with ciprofloxacin, levofloxacin or piperacillin/tazobactam at the time of breakthrough bacteremia. Almost all patients received vancomycin as definitive treatment. All the patients had transient bacteremia with an average duration of positive blood cultures of 1 day. The 30-day mortality rate was 16.67%. Mortality was not attributable to NVS bacteremia ...
To describe the rate of response to an antibiotic-lock technique (ALT) in the treatment of venous access port (VAP)-related bacteremia and to analyze the role of the reservoir in the persistence of infection, we reported the data from 12 human immunodeficiency virus-infected and 8 oncologic patients with VAP-related bacteremia. The ALT consisted of intracatheter delivery of antibiotics and was associated with a systemic antibiotic infusion. We monitored clinical manifestations and performed qualitative and quantitative blood cultures during and at the end of the treatment. Four patients had catheters removed before antibiotic treatment. Of the 16 patients who were treated with the ALT, 5 (31%) were cured, as determined by negative cultures of blood and of samples from the catheter; 2 (12.5%) were cured but had recurrent infection with another microorganism; and 9 (56%) had persistent positive cultures of blood and of samples from the tip, reservoir, or both of the VAP. Limited efficacy of the ...
|p style=text-align: left;||em|New study published in |/em|Mayo Clinic Proceedings|em| shows that statin use was associated with decreased risk of blood infection with |/em|Staphylococcus aureus|em| acquired outside of a hospital.|/em||/p|