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- Title
Characteristics of Hospital-Acquired and Community-Onset Blood Stream Infections, South-East Austria.
- Authors
Hoenigl, Martin; Wagner, Jasmin; Raggam, Reinhard B.; Prueller, Florian; Prattes, Juergen; Eigl, Susanne; Leitner, Eva; Hönigl, Katharina; Valentin, Thomas; Zollner-Schwetz, Ines; Grisold, Andrea J.; Krause, Robert
- Abstract
Purpose: The objective of this study was to compare epidemiology, causative pathogens, outcome, and levels of laboratory markers of inflammation of community-onset (i.e. community-acquired and healthcare-associated) and hospital-acquired bloodstream infection (BSI) in South-East Austria. Methods: In this prospective cohort study, 672 patients fulfilling criteria of systemic inflammatory response syndrome with positive peripheral blood cultures (277 community-onset [192 community-acquired, 85 healthcare-associated BSI], 395 hospital-acquired) were enrolled at the Medical University of Graz, Austria from 2011 throughout 2012. Clinical, microbiological, demographic as well as outcome and laboratory data was collected. Results: Escherichia coli followed by Staphylococcus aureus were the most frequently isolated pathogens. While Streptococcus spp. and Escherichia coli were isolated more frequently in patients with community-onset BSI, Enterococcus spp., Candida spp., Pseudomonas spp., Enterobacter spp., and coagulase-negative staphylococci were isolated more frequently among those with hospital-acquired BSI. With regard to the outcome, 30-day (82/395 vs. 31/277; p = 0.001) and 90-day mortality (106/395 vs. 35/277; p<0.001) was significantly higher among patients with hospital-acquired BSI even though these patients were significantly younger. Also, hospital-acquired BSI remained a significant predictor of mortality in multivariable analysis. At the time the blood cultures were drawn, patients with community-onset BSI had significantly higher leukocyte counts, neutrophil-leucocyte ratios as well as C-reactive protein, procalcitonin, interleukin-6 and serum creatinine levels when compared to those with hospital-acquired BSI. Patients with healthcare-associated BSI presented with significantly higher PCT and creatinine levels than those with community-acquired BSI. Conclusions: Hospital-acquired BSI was associated with significantly higher 30- and 90-day mortality rates. Hospital-acquired BSI therefore poses an important target for the most aggressive strategies for prevention and infection control.
- Subjects
AUSTRIA; PATHOGENIC microorganisms; NOSOCOMIAL infections; EPIDEMIOLOGY; BIOMARKERS; HEALTH outcome assessment; COMPARATIVE studies
- Publication
PLoS ONE, 2014, Vol 9, Issue 8, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0104702