[Impact of primary and intravascular catheter-related bacteremia due to coagulase-negative staphylococci in critically ill patients].
OBJECTIVE
To study the impact of coagulase-negative staphylococcal (CNS) primary and intravascular catheter-related bloodstream infection (PBSI/CRBSI) on mortality and morbidity in critically-ill patients.


METHODS
We performed a double analysis using data from the ENVIN-HELICS registry data (years 1997 to 2008): 1) We studied the clinical characteristics and outcomes of patients with CNS-induced PBSI/CRBSI and compared them with those of patients with PBSI/CRBSI caused by other pathogens; and 2) We analyzed the impact of CNS-induced PBSI/CRBSI using a case-control design (1:4) in patients without other nosocomial infections.


METHODS
167 Spanish Intensive Care Units.


METHODS
Patients admitted to ICU for more than 24 hours.


RESULTS
2,252 patients developed PBSI/CRBSI, of which 1,133 were caused by CNS. The associated mortality for PBSI/CRBSI caused by non-CNS pathogens was higher than that of the CNS group (29.8% vs. 25.9%; P=.039) due exclusively to the mortality of patients with candidemia (mortality: 45.9%). In patients without other infections, PBSI/CRBSI caused by CNS (414 patients) is an independent risk factor for a higher than average length of ICU stay (OR: 5.81, 95% CI: 4.31-7.82; P<.001).


CONCLUSIONS
Crude mortality of patients with CNS-induced BPSI/CRBSI is similar to that of patients with BPSI/CRBSI caused by other bacteria, but lower than that of patients with candidemia. Compared to patients without nosocomial infections, CNS-induced PBSI/CRBSI is associated with a significant increase in length of ICU stay.
Servicio de Medicina Intensiva, Hospital de Galdakao-Usansolo, Vizcaya, España. PEDROMARIA.OLAECHEAASTIGARRAG@osakidetza.net
P M
PM
Olaechea
F
F
Alvarez-Lerma
M
M
Palomar
J
J
Insausti
M J
MJ
López-Pueyo
A
A
Martínez-Pellús
M L
ML
Cantón
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D016022:Case-Control Studies; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D003030:Coagulase; D015897:Comorbidity; D016638:Critical Illness / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D016469:Fungemia / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control
D003030:Coagulase