Nosocomial bacteremia: Clinical significance of a single blood culture positive for coagulase-negative staphylococci

Nosocomial bacteremia: Clinical significance of a single blood culture positive for coagulase-negative staphylococci

Autor Favre, B. Google Scholar
Hugonnet, S. Google Scholar
Correa, L. Google Scholar
Sax, H. Google Scholar
Rohner, P. Google Scholar
Pittet, D. Google Scholar
Instituição Univ Hosp Geneva
Universidade Federal de São Paulo (UNIFESP)
Resumo OBJECTIVES: To describe the epidemiology of nosocomial coagulase-negative staphylococci (CoNS) bacteremia and to evaluate the clinical significance of a single blood culture positive for CoNS.DESIGN: A 3-year retrospective cohort study based on data prospectively collected through hospital-wide surveillance. Bacteremia was defined according to CDC criteria, except that a single blood culture growing CoNS was not systematically considered as a contaminant. All clinically significant blood cultures positive for CoNS nosocomial bacteremia were considered for analysis.SETTING: A large university teaching hospital in Geneva, Switzerland.RESULTS: A total of 2,660 positive blood cultures were identified. of these, 1,108 (41.7%) were nosocomial; CoNS were recovered from 411 nosocomial episodes (37.1%). Two hundred thirty-four episodes of CoNS bacteremia in the presence of signs of sepsis were considered clinically relevant and analyzed. Crude mortality and associated mortality were 24.4% and 12.8%, respectively. Associated mortality was similar among patients with one positive blood culture and those with two or more (16.2% vs 10.8%, respectively; P =.3). Mortality rates after bacteremia for patients with a single positive blood culture and for those with two or more were 15.3% and 7.0%, respectively, at day 14 (RR, 2.2; CI95, 0.87-5.46) and 20.8% and 11.3%, respectively, at day 28 (PR, 1.9; CI95, 0.9-3.8) On multivariate analysis, only age and a rapidly fatal disease were independently associated with death.CONCLUSION: CoNS bacteremia harbor a significant mortality and a single positive blood culture in the presence of signs of sepsis should be considered as clinically relevant.
Idioma Inglês
Data de publicação 2005-08-01
Publicado em Infection Control and Hospital Epidemiology. Thorofare: Slack Inc, v. 26, n. 8, p. 697-702, 2005.
ISSN 0899-823X (Sherpa/Romeo, fator de impacto)
Publicador Slack Inc
Extensão 697-702
Fonte http://dx.doi.org/10.1086/502605
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000232338800007
Endereço permanente http://repositorio.unifesp.br/handle/11600/28414

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