Epidemiology and outcome of nosocomial and community-onset bloodstream infection

D J Diekema; S E Beekmann; K C Chapin; K A Morel; E Munson; G V Doern

doi:10.1128/JCM.41.8.3655-3660.2003

Back

Epidemiology and outcome of nosocomial and community-onset bloodstream infection

Journal article

Open access

Peer reviewed

Epidemiology and outcome of nosocomial and community-onset bloodstream infection

D J Diekema, S E Beekmann, K C Chapin, K A Morel, E Munson and G V Doern

Journal of clinical microbiology, Vol.41(8), pp.3655-3660

08/2003

DOI: 10.1128/JCM.41.8.3655-3660.2003

PMCID: PMC179863

PMID: 12904371

Files and links (1)

url

https://doi.org/10.1128/JCM.41.8.3655-3660.2003View

Published (Version of record) Open Access

Abstract

We performed a prospective study of bloodstream infection to determine factors independently associated with mortality. Between February 1999 and July 2000, 929 consecutive episodes of bloodstream infection at two tertiary care centers were studied. An ICD-9-based Charlson Index was used to adjust for underlying illness. Crude mortality was 24% (14% for community-onset versus 34% for nosocomial bloodstream infections). Mortality attributed to the bloodstream infection was 17% overall (10% for community-onset versus 23% for nosocomial bloodstream infections). Multivariate logistic regression revealed the independent associations with in-hospital mortality to be as follows: nosocomial acquisition (odds ratio [OR] 2.6, P < 0.0001), hypotension (OR 2.6, P < 0.0001), absence of a febrile response (P = 0.003), tachypnea (OR 1.9, P = 0.001), leukopenia or leukocytosis (total white blood cell count of <4500 or >20000, P = 0.003), presence of a central venous catheter (OR 2.0, P = 0.0002), and presence of anaerobic organism (OR 2.5, P = 0.04). Even after adjustments were made for underlying illness and length of stay, nosocomial status of bloodstream infection was strongly associated with increased total hospital charges (P < 0.0001). Although accounting for about half of all bloodstream infections, nosocomial bloodstream infections account for most of the mortality and costs associated with bloodstream infection.

Blood Pressure

Mycoses - epidemiology

Community-Acquired Infections - etiology

Community-Acquired Infections - epidemiology

Cross Infection - etiology

Bacterial Infections - etiology

Humans

Middle Aged

Male

Cross Infection - classification

Aged, 80 and over

Adult

Female

Iowa - epidemiology

Cross Infection - epidemiology

Risk Factors

Community-Acquired Infections - classification

Treatment Outcome

Body Temperature

Mycoses - classification

Bacterial Infections - classification

Adolescent

Bacterial Infections - epidemiology

Aged

Respiratory Mechanics

Mycoses - etiology

Details

Title: Subtitle: Epidemiology and outcome of nosocomial and community-onset bloodstream infection
Creators: D J Diekema - Department of Internal Medicine, Roy J and Lucille A Carver University of Iowa College of Medicine, Iowa City, Iowa, 52242, USA
S E Beekmann
K C Chapin
K A Morel
E Munson
G V Doern
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.41(8), pp.3655-3660
DOI: 10.1128/JCM.41.8.3655-3660.2003
PMID: 12904371
PMCID: PMC179863
NLM abbreviation: J Clin Microbiol
ISSN: 0095-1137
eISSN: 1098-660X
Publisher: United States
Language: English
Date published: 08/2003
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986363502771

Metrics

15 Record Views

244 Times Cited - Web of Science