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首页> 外文期刊>Journal of Korean medical science >Bloodstream infections and clinical significance of healthcare-associated bacteremia: a multicenter surveillance study in Korean hospitals.
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Bloodstream infections and clinical significance of healthcare-associated bacteremia: a multicenter surveillance study in Korean hospitals.

机译：血流感染和医疗保健相关菌血症的临床意义：韩国医院的多中心监测研究。

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摘要

Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. Escherichia coli was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, Staphylococcus aureus (15.2%), coagulase-negative Staphylococcus (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment.
机译：医疗保健系统的最新变化已经改变了包括血液感染（BSI）在内的许多传染领域的流行病学范式。我们比较了社区获得性（CA），医院获得性（HA）和医疗保健相关（HCA）BSI的临床特征。我们对韩国9所大学医院的全国性多中心监测进行了前瞻性研究。 2006年至2007年共收集了1,605份血液分离株，其中1,144份分离株被认为是真正的病原体。 HA-BSI占48.8％，CA-BSI占33.2％，HCA-BSI占18.0％。 HA-BSI和HCA-BSI更可能患有严重合并症。大肠杆菌是CA-BSI（47.1％）和HCA-BSI（27.2％）中最常见的分离株。相反，金黄色葡萄球菌（15.2％），凝固酶阴性葡萄球菌（15.1％）是HA-BSI中常见的分离株。适当的经验性抗菌治疗率最高的是CA-BSI（89.0％），其次是HCA-BSI（76.4％）和HA-BSI（75.0％）。 HA-BSI（23.0％）的30天死亡率最高，其次是HCA-BSI（18.4％）和CA-BSI（10.2％）。通过多因素分析，高皮特评分和不适当的经验性抗生素治疗是导致死亡的独立危险因素。总之，目前的数据表明，致病性病原体的临床特征，结局和微生物特征因BSI的来源而异。特别是，HCA-BSI具有独特的临床特征，对于更适当的抗生素治疗，应将其视为不同的类别。

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