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首页> 外文期刊>Internal medicine journal >Bloodstream infections in a secondary and tertiary care hospital setting.
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Bloodstream infections in a secondary and tertiary care hospital setting.

机译：二级和三级医院的血液感染。

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BACKGROUND: Bloodstream infections (BSI) occurring in community and health-care settings vary with the patient group and treatment of underlying medical conditions. We studied the clinical infectious syndromes occurring in patients with positive blood cultures routinely obtained at a regional secondary and tertiary care hospital. METHODS: BSI were categorized as either community-acquired (C-BSI), or health-care-associated (H-BSI) acquired either as a (i) non-inpatient (outpatient) or (ii) hospital inpatient. Clinical information was collected prospectively during the 1-year study. RESULTS: There were 193 C-BSI and 230 H-BSI. The large majority of C-BSI were caused by bacterial pathogens susceptible to narrow-spectrum antibiotics, particularly in children. Cefuroxime was active against 90% of C-BSI isolates and 46% of H-BSI isolates, excluding anaerobes. Of all H-BSI, the 35% occurring in outpatients had a similar source, microbiological cause and bacterial susceptibilities to the inpatients. H-BSI wereinfrequently due to enterococci (4%), Candida (3%) or methicillin-resistant Staphylococcus aureus (0.4%). No BSI were due to vancomycin-resistant enterococci or extended-spectrum beta-lactamase producing Enterobacteriaciae. I.v. catheters, predominantly central lines, were the source of 60% of all H-BSI, mostly in haematology-oncology or neonatal patients. Mortality at 1 month was 12% overall for both C-BSI and H-BSI, varying markedly by underlying disease and increasing age (for C-BSI). CONCLUSION: In this population, C-BSI have remained susceptible to narrow-spectrum antibiotics, whereas H-BSI due to multiresistant organisms were rare. Obtaining a history of recent medical procedures is important for community patients presenting with a BSI.
机译：背景：在社区和医疗机构中发生的血流感染（BSI）随患者组和基本医疗状况的治疗而异。我们研究了在区域二级和三级护理医院常规获得的血液培养阳性的患者中发生的临床感染综合征。方法：将BSI分类为社区获得性（C-BSI）或（i）非住院患者（门诊患者）或（ii）住院患者获得的医疗保健相关（H-BSI）。在为期1年的研究中前瞻性收集了临床信息。结果：有193 C-BSI和230 H-BSI。绝大多数C-BSI是由对窄谱抗生素敏感的细菌病原体引起的，尤其是在儿童中。头孢呋辛对90％的C-BSI分离物和46％的H-BSI分离物有活性，但厌氧菌除外。在所有H-BSI中，35％的门诊患者与住院患者具有相似的来源，微生物原因和细菌敏感性。 H-BSI不常见的原因是肠球菌（4％），念珠菌（3％）或耐甲氧西林的金黄色葡萄球菌（0.4％）。没有BSI是由于产生耐万古霉素的肠球菌或产生广谱β-内酰胺酶的肠杆菌科细菌引起的。 I.v.导管（主要是中心线）是所有H-BSI的60％来源，主要发生在血液肿瘤科或新生儿患者中。 C-BSI和H-BSI的1个月总体死亡率为12％，这主要取决于潜在疾病和年龄的增长（对于C-BSI）。结论：在该人群中，C-BSI仍然易受窄谱抗生素的侵害，而由多耐药菌引起的H-BSI则很少。获得近期医疗程序的历史对于出现BSI的社区患者很重要。

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