title: [Results of an early intervention program for patients with bacteremia discharged from the Emergency Department].
abstract: OBJECTIVE
  Occult bacteremia represents 3% of blood cultures drawn in the Emergency Department. In most cases, the evolution is unknown. The aim of the study is to analyze the results obtained after implementation of an intervention program for these patients.
  
  
  METHODS
  We describe the results of an early intervention program for patients with bacteremia in the Emergency Department discharged at home, which was implemented in daily clinical activity in Costa del Sol Hospital in Marbella (Malaga). We analyze the epidemiological, microbiological, Charlson comorbidity index, Pitt bacteremia index and 30-day mortality.
  
  
  RESULTS
  During 15 months, 90 patients were located. The median age was 67 years. There was a predominance of males with 54 of cases (60%). The acquisition place was predominantly the community with 51 cases (56.6%), being the most frequent microorganism Escherichia coli with 31 cases (34.4%). The median Charlson index and the bacteremia Pitt index were 1. Thirty-eight of the cases required hospitalization (42.2%). Pitt bacteremia index>1 and exchange antibiotic treatment were the related variables with need for admission. One patient died (1.2%) and 6 patients could not be located (6.6%).
  
  
  CONCLUSIONS
  The implementation of programs of early identification and management of patients with bacteremia in Emergency Department discharged al home allows early recovery of patients who require hospital admission and antibiotic treatment optimization. In our series, mortality after early intervention was low (1.2%).
authors.affiliation: Grupo de Enfermedades Infecciosas, Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España. Electronic address: alfarco@gmail.com.
authors.forename: Alfonso
authors.initials: A
authors.lastname: del Arco-Jiménez
authors.affiliation: Grupo de Enfermedades Infecciosas, Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: Julián
authors.initials: J
authors.lastname: Olalla-Sierra
authors.affiliation: Grupo de Enfermedades Infecciosas, Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: Javier
authors.initials: J
authors.lastname: de la Torre-Lima
authors.affiliation: Grupo de Enfermedades Infecciosas, Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Prada-Pardal
authors.affiliation: Unidad de Apoyo a la Investigación, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rivas-Ruiz
authors.affiliation: Unidad de Microbiología, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Sánchez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D058387:Candidemia / Q000188:drug therapy / Q000401:mortality; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D015897:Comorbidity; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D061345:Early Medical Intervention; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010351:Patient Discharge; D015397:Program Evaluation; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacteremia; Bacteriemia; Emergency Department; Intervention program; Programa de intervención; Servicio de Urgencias