Clinical and microbiological features of community-acquired and nosocomial bloodstream infections in the surgical department of a tertiary-care hospital in Beijing.
BACKGROUND
Bloodstream infections (BSIs) remain a major cause of morbidity and mortality in patients undergoing surgery. This study aimed at elucidating the clinical characteristics of community-acquired BSIs (CABs) and nosocomial BSIs (nBSIs) in patients admitted to the surgical wards of a teaching hospital in Beijing, China.


METHODS
This cross-sectional study compared 191 episodes of BSIs in 4074 patients admitted to the surgical wards between January 2008 and December 2011. Cases of BSIs were classified as CABs or nBSIs, and the characteristics, relevant treatments, and outcomes of CABs and nBSIs were compared.


RESULTS
Of the 191 BSIs, 52 (27.2%) and 139 (72.8%) were CABs and nBSIs, respectively. Escherichia coli, coagulasenegative staphylococci, and Klebsiella spp, were the most frequently isolated microorganisms. There were significant differences between CABs and nBSIs with respect to the use of hormonal drugs, ventilation, acute physiology and chronic health evaluation (APACHE) II and American Society of Anesthesiologists scores, and prevalence of cancer (P < 0.05). Empirical antibacterial therapy did not decrease the crude mortality, but multivariate analysis showed that high APACHE II was independently associated with a risk of mortality (odds ratio = 0.97, 95% confidence interval: 0.93-1.02 for APACHE II).


CONCLUSIONS
We found significant differences in the clinical characteristics of surgical patients with CABs and nBSIs. The outcome of patients seems to be related to high APACHE II scores.
Department of Gastroenterological Surgery, Peking University People's Hospital, Peking University, Beijing 100044, China; Department of Hepatobiliary Surgery, the First Affiliated Hospital, Shihezi University, Shihezi, Xinjiang 832008, China.
You
Y
Lü
Peng
P
Guo
Ying-Jiang
YJ
Ye
Hui
H
Wang
Zhan-Long
ZL
Shen
Qi
Q
Wang
Chun-Jiang
CJ
Zhao
Zhi-Dong
ZD
Gao
Xin
X
Zhang
Jian
J
Cao
Ke-Wei
KW
Jiang
Shan
S
Wang
D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000453:epidemiology*; D002681:China; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D003430:Cross-Sectional Studies; D004926:Escherichia coli / Q000472:pathogenicity; D005260:Female; D013502:General Surgery / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D008297:Male; D013210:Staphylococcus / Q000472:pathogenicity
D000900:Anti-Bacterial Agents