[Trends for bacteremia and risk factors for death in a tertiary hospital in Mexico City. 1981-1992].
OBJECTIVE
To describe the trends and risk factors of death for bacteremia in adult from a tertiary-care center from 1981 to 1992.


METHODS
We randomly included 20% of bacteremic episodes per year.


RESULTS
47,618 blood-cultures from 19,530 patients, 3428 patients (17.6%) had bacteremia (285/y). From 600 episodes (50/y), 307 were from men, 368 were hospital-acquired (HA), and 88% were monomicrobial. Diabetes mellitus was seen in 103 cases, cirrhosis of the liver in 98, and AIDS in 33, among others. The main microorganisms were: Escherichia coli (177), Klebsiella pneumoniae (53), Enterobacter (50), Salmonella (45) and Pseudomonas aeruginosa (35); coagulase-negative staphylococci (CNS) (116), Staphylococcus aureus (56), and enterococci (22), and Candida (20). CNS decreased during the study (p < 0.01), but Candida spp., Stenotrophomonas maltophilia and enterococci increased (p < 0.01). The crude mortality of the HA bacteremia was 70.8%, and 29.2% in the case of community-acquired, the mortality attributable to HA bacteremia was 41.6%. The main risk factors were: cardiac valvular disease (p < 0.001), stay at the intensive-care unit (p < 0.001), sepsis (p < 0.001), and pneumonia (p < 0.001).


CONCLUSIONS
Bacteremia had a significant impact on mortality during the study period that has not change despite opportune therapy, Enterococci and candida have emerged as significant pathogens.
Sifuentes-Osornio
J
J
Laboratorio de Microbiología Clínica, Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, México, D.F. 14000. México. JSO@quetzal.innsz.mx
Guerrero-Almeida
M C
MC
Ponce de León-Garduño
L A
LA
Guerrero-Almeida
M L
ML
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D002177:Candidiasis / Q000453:epidemiology; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D004756:Enterobacteriaceae Infections / Q000453:epidemiology; D005260:Female; D016469:Fungemia / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D015993:Life Tables; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology; D016019:Survival Analysis; D014504:Urban Health / Q000706:statistics & numerical data