Risk factors for mortality in patients with nosocomial Gram-negative rod bacteremia

C. Karakoc, R. Tekin, Z. Yesilbag, A. Cagatay

Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Istanbul University, Istanbul, Turkey. ceftpublications@gmail.com

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• Infectious Diseases

BACKGROUND: The percentage of hospital-acquired bloodstream infections associated with Gram-negative bacilles has decreased during last decade but it is still a major cause of morbidity and mortality.

OBJECTIVES: The aim of this study was to determine the outcome of Gram-negative rod (GNR) bacteremia, which is an important clinical problem with high mortality rates, and the risk factors for GNR related mortality in our Clinic.

MATERIALS AND METHODS: During the study period, 520 episodes of bacteremia were detected in 411 patients. Only patients with GNR bacteremia in blood cultures were included in the study (n = 197). Among 197 patients fulfilling study criteria, GNR were grown in 239 samples.

RESULTS: Escherichia coli (n = 97, 40.5%), Klebsiella pneumoniae (n = 54, 22.5%), Pseudomonas aeruginosa (n= 24, 10%), Acinetobacter baumannii (n = 24, 10%) were the most commonly isolated bacteria. The most frequently identified infection sources of bacteremia were pneumonia (n = 35, 17.7%), catheter-related infections (n = 24, 12.2%), urinary tract infections (n = 20, 10%). In multivariate analysis, it was found that the GNR bacteremia mortality risk increased in patients treated in intensive care units (ICU) (OR: 0.2, p = 0.03) and patients with ventilatory support (OR: 20.8, p = 0.05).

CONCLUSIONS: In clinical practice of the hospital settings, efforts should concentrate on preventive measures for nosocomial infections since pneumonia, catheter-related infections, and urinary infections appear to be the most frequent causes of secondary bacteremia.

 

 

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