title: Outcomes and Predictive Factors Associated with Adequacy of Antimicrobial Therapy in Patients with Central Line-Associated Bloodstream Infection.
abstract: BACKGROUND
  Central venous catheters are significant risk factors for bloodstream infection (BSI), which are directly associated with increased morbidity and mortality.
  
  
  METHODS
  This study was a retrospective cohort study for the time period of July 2011-June 2014 in patients with central line-associated bloodstream infection (CLABSI) to determine the microbiological profile and antimicrobial adequacy of patients with CLABSI in a tertiary hospital.
  
  
  RESULTS
  One hundred and twenty-one CLABSI cases were identified. Ninety-two percent (n= 111) of patients had monomicrobial BSI. Gram-negative bacteria were the most prevalent (49%,n= 63), withKlebsiellaspp. predominating (30%,n= 19). Among the Gram-positive bacteria (n= 43, 33%), coagulase-negative staphylococci was the major pathogen (58%,n= 25), and all isolates were methicillin resistant. Antimicrobial therapy was assessed as adequate in 81% (n= 98) of cases. In-hospital mortality was 36% (n= 43 cases).
  
  
  CONCLUSIONS
  Our CLABSI patients had a high mortality, although antimicrobial therapy was appropriate. Gram-negative bacteria were responsible for almost half of the cases and there was a high rate of bacteria resistance to extended-spectrum antibiotics.
authors.affiliation: Division of Medical Practice, Hospital Israelita Albert Einstein , São Paulo , Brazil.
authors.forename: Paula Kiyomi Onaga
authors.initials: PK
authors.lastname: Yokota
authors.affiliation: Division of Medical Practice, Hospital Israelita Albert Einstein , São Paulo , Brazil.
authors.forename: Alexandre Rodrigues
authors.initials: AR
authors.lastname: Marra
authors.affiliation: Division of Medical Practice, Hospital Israelita Albert Einstein , São Paulo , Brazil.
authors.forename: Talita Rantin
authors.initials: TR
authors.lastname: Belucci
authors.affiliation: Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein , São Paulo , Brazil.
authors.forename: Elivane da Silva
authors.initials: ED
authors.lastname: Victor
authors.affiliation: Division of Medical Practice, Hospital Israelita Albert Einstein , São Paulo , Brazil.
authors.forename: Oscar Fernando Pavão
authors.initials: OF
authors.lastname: Dos Santos
authors.affiliation: Department of Internal Medicine, University of Iowa Carver College of Medicine , Iowa City, IA , USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Edmond
keywords: blood stream infection; central line-associated infection; central venous catheters; inadequate antimicrobial therapy; mortality