[Analysis of critically ill patients with bacteremia].
OBJECTIVE
To study the epidemiology of bacteremia of critically ill patients and the mortality associated with bacteremia and risk factors for death in an intensive care unit.


METHODS
75 patients with 116 episodes of bacteremia were retrospectively studied.


RESULTS
The mortality rate of the patients was 43%. Staphylococci (29%), Enterococci (12%), Class I inducible beta-lactamase-producing Enterobacter (12%), extensive spectrum beta-lactamase-producing Enterobacter (10%) were the most common pathogens, among which gram-positive organisms constitute a major part. The most commonly affected organs were respiratory (77%), hepatic (53%), circulatory (53%), gastrointestinal (50%), renal (47%), central nervous (36%), and hemopoietic systems (27%). Multiple organ failure accounted for 76%. Univariate analysis revealed that the severity of underlying illness, multiple organ failure (MOF), septic shock, hepatic failure, renal failure and infection focus were the risk factors for in-hospital death (P < 0.05). Cox proportional hazard model analysis suggested central nervous system failure, septic shock, hemopoietic failure, hepatic failure and respiratory manipulation significantly affected the survival time of patients with bacteremia (P < 0.05).


CONCLUSIONS
Gram-positive organisms are major pathogens of bacteremia in critically ill patients. Antibiotic therapy can not prevent the occurence of bacteremia, nor can it improve the prognosis.
Department of Critical Care Medicine, Peking Union Medical College Hospital, Beijing.
B
B
Du
D
D
Chen
H
H
Li
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D016638:Critical Illness; D003428:Cross Infection; D004754:Enterobacter; D004756:Enterobacteriaceae Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology*