Rev Esp Quimioter 2013:26(1):21-29

Morbidity and mortality associated with primary and catheter-related bloodstream infections in critically ill patients                                  
 

P. M. OLAECHEA, M. PALOMAR,  F. ÁLVAREZ-LERMA,  J. J. OTAL,  J. INSAUSTI,  M. J. LÓPEZ-PUEYO Y EL GRUPO ENVIN-HELICS                

Purpose. To analyze the impact of primary and catheter related bloodstream infections (PBSI/CRBSI) on morbidity and mortality.
Methods. A matched case-control study (1:4) was carried out on a Spanish epidemiological database of critically ill patients (ENVIN-HELICS). To determine the risk of death in patients with PBSI/CRBSI a matched Cox proportional hazard regression analysis was performed.
Results. Out of the 74,585 registered patients, those with at least one episode of monomicrobial PBSI/CRBSI were selected and paired with patients without PBSI/CRBSI for demographic and diagnostic criteria and seriousness of their condition on admission to the Intensive Care Unit (ICU). For mortality analysis, 1,879 patients with PBSI/CRBSI were paired with 7,516 controls. The crude death rate in the ICU was 28.1% among the cases and 18.7% among the controls. Attributable mortality 9.4% (HR:1.20; 95% confidence interval: 1.07–1.34; p<0.001). Risk of death varied according to the source of infection, aetiology, moment of onset of bloodstream infection and severity on admission to the ICU. The median stay in the ICU of patients who survived PBSI/CRBSI was 13 days longer than the controls, also varying according to aetiology, moment of onset of bloodstream infection and severity on admission.
Conclusions. Acquisition of PBSI/CRBSI in critically ill patients significantly increases mortality and length of ICU stay, which justifies prevention efforts.de prevención.

Rev Esp Quimioter 2013:26(1):21-29 [pdf]