title: Timing and aetiology of bacterial infections in a liver intensive care unit.
abstract: We undertook a prospective study of 887 consecutive adult patients admitted over an 11 year period to a liver intensive care unit. One or more bacterial infections occurred in 335 (37.8%) patients. Gram-positive cocci predominated. In relation to the date of admission these infections occurred in a statistically significant sequence. Streptococci infections were earliest (median time to infection two days), followed by Staphylococcus aureus (three days), coagulase-negative staphylococci (six days) and enterococci (eight days). Escherichia coli infections occurred earlier than those due to klebsiella-enterobacter (two vs seven days; P = 0.0001) and, overall, Enterobacteriaceae earlier than non-fermentative Gram-negatives (four vs. eight days; P = 0.0081). This study contributes to the management of high-dependency patients by confirming statistically the timing and sequence of infecting bacteria in patients with acute liver failure.
authors.affiliation: South London Public Health Laboratory, Medical Microbiology, King's College Hospital, Denmark Hill, London, UK. jimwade@btinternet.com
authors.forename: J
authors.initials: J
authors.lastname: Wade
authors.forename: N
authors.initials: N
authors.lastname: Rolando
authors.forename: J
authors.initials: J
authors.lastname: Philpott-Howard
authors.forename: J
authors.initials: J
authors.lastname: Wendon
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology*; D006801:Humans; D007362:Intensive Care Units; D017114:Liver Failure, Acute / Q000150:complications*; D008131:London / Q000453:epidemiology; D011446:Prospective Studies; D013997:Time Factors