title: [Incidence and mortality of bacteremia in a public hospital in Santiago].
abstract: BACKGROUND
  The incidence of bacteremia has increased over the last decade due to the aging of the population and the wide implementation of invasive nosocomial procedures and wide-spectrum antimicrobial treatments.
  
  
  OBJECTIVE
  To assess the epidemiology of hospital and ambulatory bacteremias in a public hospital in Santiago.
  
  
  METHODS
  A prospective longitudinal cohort study of laboratory-confirmed adult patients with bacteremia was undertaken at a public hospital in Santiago, between June 1, 2007 and April 30, 2008. Demographic, clinical, and laboratory data was collected into a standardized study-specific form.
  
  
  RESULTS
  In the study period, 253 cases of true bacteremia were identified, with an incidence of 11 per 1,000 patient discharges (63.6% nosocomial, 36.7% fatal). Only 2/3 of the cohort was alive at day 28 of hospitalization. Variables associated with mortality were age with a hazard ratio (HR) of 2.31; (95% confidence intervals (CI) 1.42- 3.77); female gender (HR, 1.70; 95% CI 1.06- 2.71); shock (HR, 3.24; 95%CI 2.01-5.22); and C reactive protein (HR, 2.10; 95% CI 1.17- 3.78). The variable associated with lower mortality was surgery (HR, 0.43; 95% CI 0.25-0.75). Selective empiric treatment did not improve survival.
  
  
  CONCLUSIONS
  Besides age and gender, survival can be influenced by modifiable variables such as presence of shock and surgical intervention, which may provide an opportunity to improve outcomes.
authors.affiliation: Departamento de Infectología, Complejo Asistencial Barros Luco Trudeau, Santiago, Chile. pilargambra@yahoo.es
authors.forename: María
authors.initials: M
authors.lastname: Gambra
authors.forename: Jeferson
authors.initials: J
authors.lastname: Flores
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ramírez
authors.forename: Sofía
authors.initials: S
authors.lastname: Palma
authors.forename: Pedro
authors.initials: P
authors.lastname: Zitko
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Valenzuela
authors.forename: Carlos
authors.initials: C
authors.lastname: Beltrán
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000401:mortality*; D002677:Chile / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006779:Hospitals, Public; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult