title: Risk factors for mortality in patients with nosocomial Gram-negative rod bacteremia.
abstract: BACKGROUND
  The percentage of hospital-acquired bloodstream infections associated with Gram-negative bacilles has decreased during last decade but it is still a major cause of morbidity and mortality.
  
  
  OBJECTIVE
  The aim of this study was to determine the outcome of Gram-negative rod (GNR) bacteremia, which is an important clinical problem with high mortality rates, and the risk factors for GNR related mortality in our Clinic.
  
  
  METHODS
  During the study period, 520 episodes of bacteremia were detected in 411 patients. Only patients with GNR bacteremia in blood cultures were included in the study (n = 197). Among 197 patients fulfilling study criteria, GNR were grown in 239 samples.
  
  
  RESULTS
  Escherichia coli (n = 97, 40.5%), Klebsiella pneumoniae (n = 54, 22.5%), Pseudomonas aeruginosa (n= 24, 10%), Acinetobacter baumannii (n = 24, 10%) were the most commonly isolated bacteria. The most frequently identified infection sources of bacteremia were pneumonia (n = 35, 17.7%), catheter-related infections (n = 24, 12.2%), urinary tract infections (n = 20, 10%). In multivariate analysis, it was found that the GNR bacteremia mortality risk increased in patients treated in intensive care units (ICU) (OR: 0.2, p = 0.03) and patients with ventilatory support (OR: 20.8, p = 0.05).
  
  
  CONCLUSIONS
  In clinical practice of the hospital settings, efforts should concentrate on preventive measures for nosocomial infections since pneumonia, catheter-related infections, and urinary infections appear to be the most frequent causes of secondary bacteremia.
authors: Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Istanbul University, Istanbul, Turkey.
authors: C
authors: C
authors: Karakoc
authors: R
authors: R
authors: Tekin
authors: Z
authors: Z
authors: Yeşilbağ
authors: A
authors: A
authors: Cagatay
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000382:microbiology / Q000401:mortality*; D003428:Cross Infection / Q000382:microbiology / Q000401:mortality*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology / Q000401:mortality*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors