Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria.
<h4>Purpose</h4>The objective of this study was to compare epidemiology, causative pathogens, outcome, and levels of laboratory markers of inflammation of community-onset (i.e. community-acquired and healthcare-associated) and hospital-acquired bloodstream infection (BSI) in South-East A...
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Public Library of Science (PLoS)
2014
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oai:doaj.org-article:c4c1cad31852472d9ecb9d1d2e4cd7b42021-11-25T06:05:34ZCharacteristics of hospital-acquired and community-onset blood stream infections, South-East Austria.1932-620310.1371/journal.pone.0104702https://doaj.org/article/c4c1cad31852472d9ecb9d1d2e4cd7b42014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25105287/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Purpose</h4>The objective of this study was to compare epidemiology, causative pathogens, outcome, and levels of laboratory markers of inflammation of community-onset (i.e. community-acquired and healthcare-associated) and hospital-acquired bloodstream infection (BSI) in South-East Austria.<h4>Methods</h4>In this prospective cohort study, 672 patients fulfilling criteria of systemic inflammatory response syndrome with positive peripheral blood cultures (277 community-onset [192 community-acquired, 85 healthcare-associated BSI], 395 hospital-acquired) were enrolled at the Medical University of Graz, Austria from 2011 throughout 2012. Clinical, microbiological, demographic as well as outcome and laboratory data was collected.<h4>Results</h4>Escherichia coli followed by Staphylococcus aureus were the most frequently isolated pathogens. While Streptococcus spp. and Escherichia coli were isolated more frequently in patients with community-onset BSI, Enterococcus spp., Candida spp., Pseudomonas spp., Enterobacter spp., and coagulase-negative staphylococci were isolated more frequently among those with hospital-acquired BSI. With regard to the outcome, 30-day (82/395 vs. 31/277; p = 0.001) and 90-day mortality (106/395 vs. 35/277; p<0.001) was significantly higher among patients with hospital-acquired BSI even though these patients were significantly younger. Also, hospital-acquired BSI remained a significant predictor of mortality in multivariable analysis. At the time the blood cultures were drawn, patients with community-onset BSI had significantly higher leukocyte counts, neutrophil-leucocyte ratios as well as C-reactive protein, procalcitonin, interleukin-6 and serum creatinine levels when compared to those with hospital-acquired BSI. Patients with healthcare-associated BSI presented with significantly higher PCT and creatinine levels than those with community-acquired BSI.<h4>Conclusions</h4>Hospital-acquired BSI was associated with significantly higher 30- and 90-day mortality rates. Hospital-acquired BSI therefore poses an important target for the most aggressive strategies for prevention and infection control.Martin HoeniglJasmin WagnerReinhard B RaggamFlorian PruellerJuergen PrattesSusanne EiglEva LeitnerKatharina HöniglThomas ValentinInes Zollner-SchwetzAndrea J GrisoldRobert KrausePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 8, p e104702 (2014) |
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Medicine R Science Q |
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Medicine R Science Q Martin Hoenigl Jasmin Wagner Reinhard B Raggam Florian Prueller Juergen Prattes Susanne Eigl Eva Leitner Katharina Hönigl Thomas Valentin Ines Zollner-Schwetz Andrea J Grisold Robert Krause Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria. |
| description |
<h4>Purpose</h4>The objective of this study was to compare epidemiology, causative pathogens, outcome, and levels of laboratory markers of inflammation of community-onset (i.e. community-acquired and healthcare-associated) and hospital-acquired bloodstream infection (BSI) in South-East Austria.<h4>Methods</h4>In this prospective cohort study, 672 patients fulfilling criteria of systemic inflammatory response syndrome with positive peripheral blood cultures (277 community-onset [192 community-acquired, 85 healthcare-associated BSI], 395 hospital-acquired) were enrolled at the Medical University of Graz, Austria from 2011 throughout 2012. Clinical, microbiological, demographic as well as outcome and laboratory data was collected.<h4>Results</h4>Escherichia coli followed by Staphylococcus aureus were the most frequently isolated pathogens. While Streptococcus spp. and Escherichia coli were isolated more frequently in patients with community-onset BSI, Enterococcus spp., Candida spp., Pseudomonas spp., Enterobacter spp., and coagulase-negative staphylococci were isolated more frequently among those with hospital-acquired BSI. With regard to the outcome, 30-day (82/395 vs. 31/277; p = 0.001) and 90-day mortality (106/395 vs. 35/277; p<0.001) was significantly higher among patients with hospital-acquired BSI even though these patients were significantly younger. Also, hospital-acquired BSI remained a significant predictor of mortality in multivariable analysis. At the time the blood cultures were drawn, patients with community-onset BSI had significantly higher leukocyte counts, neutrophil-leucocyte ratios as well as C-reactive protein, procalcitonin, interleukin-6 and serum creatinine levels when compared to those with hospital-acquired BSI. Patients with healthcare-associated BSI presented with significantly higher PCT and creatinine levels than those with community-acquired BSI.<h4>Conclusions</h4>Hospital-acquired BSI was associated with significantly higher 30- and 90-day mortality rates. Hospital-acquired BSI therefore poses an important target for the most aggressive strategies for prevention and infection control. |
| format |
article |
| author |
Martin Hoenigl Jasmin Wagner Reinhard B Raggam Florian Prueller Juergen Prattes Susanne Eigl Eva Leitner Katharina Hönigl Thomas Valentin Ines Zollner-Schwetz Andrea J Grisold Robert Krause |
| author_facet |
Martin Hoenigl Jasmin Wagner Reinhard B Raggam Florian Prueller Juergen Prattes Susanne Eigl Eva Leitner Katharina Hönigl Thomas Valentin Ines Zollner-Schwetz Andrea J Grisold Robert Krause |
| author_sort |
Martin Hoenigl |
| title |
Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria. |
| title_short |
Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria. |
| title_full |
Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria. |
| title_fullStr |
Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria. |
| title_full_unstemmed |
Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria. |
| title_sort |
characteristics of hospital-acquired and community-onset blood stream infections, south-east austria. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2014 |
| url |
https://doaj.org/article/c4c1cad31852472d9ecb9d1d2e4cd7b4 |
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