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- Title
Clinical and microbiological characteristics of polymicrobial bacteremia: a retrospective, multicenter study.
- Authors
Fukushima, Shinnosuke; Hagiya, Hideharu; Fujita, Koji; Kamiyama, Shinya; Yamada, Haruto; Kishida, Masayuki; Otsuka, Fumio
- Abstract
Purpose: To clarify the clinical and microbial characteristics of polymicrobial bacteremia (PMB) to contribute to improvements in clinical diagnosis and effective early treatment. Methods: This retrospective multicenter study used data from three acute-care hospitals in Okayama Prefecture, Japan, collected between January 2014 and March 2019. We reviewed the demographics, comorbidities, organisms isolated, infectious focus, and 30-day mortality of patients with PMB. Results: Of the 7233 positive blood cultures, 808 (11.2%) were positive for more than one organism. Of the patients with bacteremia, 507 (7.0%) had PMB, of whom 65.3% were male. Infectious foci were identified in 78.3% of the cases, of which intra-abdominal infections accounted for 47.1%. A combination of Gram-positive cocci (GPC) (chain form) and Gram-negative rods (GNR) accounted for 32.9% of the cases, and GPC/GNR and GNR/GNR patterns were significantly associated with intra-abdominal infections. The 30-day mortality rate of patients with PMB was 18.1%, with a median of 7.5 days from diagnosis to death. The mortality in patients with an infectious focus identified was significantly lower than that in patients with an unknown focus (16.3% vs. 24.5%; p = 0.031). Conclusions: Intra-abdominal infections were the most common source of PMB, and were strongly associated with a Gram-staining combination pattern of GPC (chain form)/GNR. PMB cases with an unknown focus had a poorer prognosis, highlighting the importance of early diagnosis and appropriate treatment.
- Subjects
JAPAN; MORTALITY prevention; BACTEREMIA; RESEARCH; ACADEMIC medical centers; LOG-rank test; RETROSPECTIVE studies; ACQUISITION of data; MANN Whitney U Test; FISHER exact test; CROSS infection; METHICILLIN-resistant staphylococcus aureus; INTRA-abdominal infections; GRAM-positive bacterial infections; MIXED infections; SYMPTOMS; CRITICAL care medicine; DESCRIPTIVE statistics; MEDICAL records; PUBLIC hospitals; CHI-squared test; KAPLAN-Meier estimator; SURVIVAL analysis (Biometry); COMMUNITY-acquired infections; STAPHYLOCOCCUS aureus; GRAM-negative bacterial diseases; DATA analysis software; MICROBIAL sensitivity tests; EARLY diagnosis; EARLY medical intervention; DISEASE risk factors
- Publication
Infection, 2022, Vol 50, Issue 5, p1233
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-022-01799-7