Department of Preventive Medicine and Public Health of the Universidad de La Laguna, Tenerife, Spain.
Research Support Service, Nurses Association of Santa Cruz de Tenerife, Spain.
J Infect Public Health. 2019 Jan-Feb;12(1):37-42. doi: 10.1016/j.jiph.2018.08.011. Epub 2018 Sep 25.
Secondary bacteraemia infections (SBI) are poorly studied. We analyse the epidemiology of nosocomial SBI, potential risk factors and mortality of affected patients.
Prospective study of patients with bacteraemia from 2009 to 2014 in a tertiary hospital. For each SBI was recorded: primary source of infection, aetiological agent, demographic data, intrinsic and extrinsic risk factors and mortality during the episode.
429/1918 episodes of Nosocomial Bacteraemia (NB) (22%) were SBI (average Incidence Density: 0.41% days of admission). Onco-hematological services had the highest Incidence Density of SBI. Surgical Site Infection-SBI (SSI-BSI) was the most frequent SBI (27%), followed by Urinary Tract Infection-SBI (UTI-BSI) (24%). Gram-negative bacteria were the most prevalent microorganism (61.1%). The median interval between SBI episodes to discharge was 37±59days. Mortality rate was 29%. These patients had many intrinsic and extrinsic risk factors such as urinary catheterization (68%), CVC (69%), Arterial hypertension (48%) and hospitalization in the six previous months (45%). Mean age was significantly higher in patients with UTI-BSI and SSI-BSI. Average stay from admission to the development of bacteraemia was statistically lower in patients with Intra-abdominal Infection bacteraemia (IAB-BSI). Patient with SSI-BSI had oncologic processes and had undergone for more Mechanical ventilation than UTI-SSBI and Respiratory Tract Infections Bacteraemia (RTI-BSI). The use of CVC was significantly higher in RTI-BSI.
SBI accounts for almost a quarter of all NB. Patients has multiple comorbidities, increases hospital stay and mortality. It would be necessary to establish measures to rapidly diagnose and treat the primary infection, in order to prevent the onset of SBI.
继发性菌血症感染（SBI）研究较少。我们分析了医院获得性 SBI 的流行病学、潜在危险因素和感染患者的死亡率。
对 2009 年至 2014 年在一家三级医院发生菌血症的患者进行前瞻性研究。每例 SBI 记录：感染的主要来源、病原体、人口统计学数据、固有和外在危险因素以及发病期间的死亡率。
1918 例医院获得性菌血症（NB）（22%）中有 429 例（平均发病率密度：0.41%住院天数）为 SBI。肿瘤血液病科的 SBI 发病率密度最高。手术部位感染-菌血症（SSI-BSI）是最常见的 SBI（27%），其次是尿路感染-菌血症（UTI-BSI）（24%）。革兰氏阴性菌是最常见的微生物（61.1%）。SBI 发作至出院的中位间隔为 37±59 天。死亡率为 29%。这些患者有许多内在和外在的危险因素，如导尿管（68%）、CVC（69%）、动脉高血压（48%）和 6 个月前住院（45%）。UTI-BSI 和 SSI-BSI 患者的平均年龄明显较高。从入院到发生菌血症的平均住院时间在腹腔内感染菌血症（IAB-BSI）患者中统计学上较低。SSI-BSI 患者有肿瘤疾病，接受的机械通气次数多于 UTI-SSBI 和呼吸道感染菌血症（RTI-BSI）。RTI-BSI 中 CVC 的使用率明显较高。
SBI 占所有 NB 的近四分之一。患者有多种合并症，增加了住院时间和死亡率。有必要制定措施快速诊断和治疗原发性感染，以防止 SBI 的发生。
