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2001, Number 3

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Gac Med Mex 2001; 137 (3)

Trends of bacteremia and analysis of the risk factors for death in a tertiary-care center in Mexico City. 1981 a 1992

Sifuentes-Osornio J, Guerrero-Almeida MC, Ponce de León-Garduño LA, Guerrero-Almeida ML

Language: Spanish
References: 60
Page: 191-202
PDF size: 117.16 Kb.


ABSTRACT

Objective: To describe the trends and risk factors of death for bacteremia in adult from a tertiary-care center from 1981 to 1992. Material and methods: We randomly included 20% of bacteremic episodes per year. Results: 47,618 blood-cultures from 19,530 patients, 3428 patients (17.6%) had bacteremia (285/y). From 600 episodes (50/y), 307 were from men, 368 were hospital-acquired (HA), and 88% were monomicrobial. Diabetes mellitus was seen in 103 cases, cirrhosis of the liver in 98, and AIDS in 33, among others. The main microorganisms were: Escherichia coli (177), Klebsiella pneumoniae (53), Enterobacter (50), Salmonella (45) and Pseudomonas aeruginosa (35); coagulase-negative staphylococci (CNS) (116), Staphylococcus aureus (56), and enterococci (22), and Candida (20). CNS decreased during the study (p‹0.01), but Candida spp., Stenotrophomonas maltophilia and enterococci increased (p‹0.0 1). The crude mortality of the HA bacteremia was 70.8%, and 29.2% in the case of community-acquired, the mortality attributable to HA bacteremia was 41.6%. The main risk factors were: cardiac valvular disease (p‹0.001), stay at the intensive-care unit (p‹0.001), sepsis (p‹0.001), and pneumonia (p‹0.001). Discussion: Bacteremia hçad a significant impact on mortality during the study period that has not change despite opportune therapy, Enterococci and candida have emerged as significant pathogens.


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