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Outcomes and predictive factors associated with adequacy of antimicrobial therapy in patients with central line-associated bloodstream infection
Journal article   Open access   Peer reviewed

Outcomes and predictive factors associated with adequacy of antimicrobial therapy in patients with central line-associated bloodstream infection

Paula Kiyomi Onaga Yokota, Alexandre Rodrigues Marra, Talita Rantin Belucci, Oscar Fernando Pavão dos Santos, Elivane da Silva Victor and Michael B Edmond
Frontiers in Public Health, Vol.4(DEC), 284
2016
DOI: 10.3389/fpubh.2016.00284
PMCID: PMC5179579
PMID: 28066761
url
https://doi.org/10.3389/fpubh.2016.00284View
Published (Version of record) Open Access

Abstract

Background: Central venous catheters (CVCs) are significant risk factors for bloodstream infection (BSI), which are directly associated with increased morbidity and mortality. Methods: This study was a retrospective cohort study for the time period July 2011 to June 2014, in patients with central line-associated bloodstream infection (CLABSI) to determine the microbiological profile and antimicrobial adequacy of patients with CLABSI in a tertiary hospital. Results: One hundred and twenty one CLABSI cases were identified. 92% (n= 111) of patients had monomicrobial BSI. Gram negative bacteria were the most prevalent (49%, n= 63), with Klebsiella spp predominating (30%, n= 19). Among the Gram-positive bacteria (n= 43, 33%), coagulase-negative staphylococci was the major pathogen (58%, n= 25), and all isolates were methicillin resistant. Antimicrobial therapy was assessed as adequate in 81% (n= 98) of cases. In-hospital mortality was 36% (n=43 cases). Conclusions: Our CLABSI patients had a high mortality, although antimicrobial therapy was appropriate. Gram negative bacteria were responsible for almost half of the cases and there was a high rate of bacteria resistance to extended-spectrum antibiotics.

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