del Arco-Jiménez Alfonso, Olalla-Sierra Julián, de la Torre-Lima Javier, Prada-Pardal José Luis, Rivas-Ruiz Francisco, Fernández-Sánchez Fernando
Grupo de Enfermedades Infecciosas, Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
Grupo de Enfermedades Infecciosas, Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
Med Clin (Barc). 2014 Feb 4;142(3):107-10. doi: 10.1016/j.medcli.2013.05.050. Epub 2013 Nov 7.
Occult bacteremia represents 3% of blood cultures drawn in the Emergency Department. In most cases, the evolution is unknown. The aim of the study is to analyze the results obtained after implementation of an intervention program for these patients.
We describe the results of an early intervention program for patients with bacteremia in the Emergency Department discharged at home, which was implemented in daily clinical activity in Costa del Sol Hospital in Marbella (Malaga). We analyze the epidemiological, microbiological, Charlson comorbidity index, Pitt bacteremia index and 30-day mortality.
During 15 months, 90 patients were located. The median age was 67 years. There was a predominance of males with 54 of cases (60%). The acquisition place was predominantly the community with 51 cases (56.6%), being the most frequent microorganism Escherichia coli with 31 cases (34.4%). The median Charlson index and the bacteremia Pitt index were 1. Thirty-eight of the cases required hospitalization (42.2%). Pitt bacteremia index>1 and exchange antibiotic treatment were the related variables with need for admission. One patient died (1.2%) and 6 patients could not be located (6.6%).
The implementation of programs of early identification and management of patients with bacteremia in Emergency Department discharged al home allows early recovery of patients who require hospital admission and antibiotic treatment optimization. In our series, mortality after early intervention was low (1.2%).
隐匿性菌血症占急诊科采集血培养样本的3%。在大多数情况下，其病情发展情况不明。本研究的目的是分析针对这些患者实施干预计划后所获得的结果。
我们描述了在马拉加省马贝拉市太阳海岸医院日常临床活动中实施的一项针对急诊科菌血症患者并在家中出院的早期干预计划的结果。我们分析了流行病学、微生物学、查尔森合并症指数、皮特菌血症指数和30天死亡率。
在15个月期间，找到了90名患者。中位年龄为67岁。男性占主导，有54例（60%）。感染源主要是社区，有51例（56.6%），最常见的微生物是大肠杆菌，有31例（34.4%）。查尔森指数和菌血症皮特指数的中位数均为1。38例患者需要住院治疗（42.2%）。皮特菌血症指数>1和更换抗生素治疗是与需要住院相关的变量。1例患者死亡（1.2%），6例患者无法找到（6.6%）。
在急诊科实施针对菌血症患者并在家中出院的早期识别和管理计划，能够使需要住院治疗的患者早日康复，并优化抗生素治疗。在我们的系列研究中，早期干预后的死亡率较低（1.2%）。
