[Trends for bacteremia and risk factors for death in a tertiary hospital in Mexico City. 1981-1992]

Gac Med Mex. 2001 May-Jun;137(3):191-202.
[Article in Spanish]

Abstract

Objective: To describe the trends and risk factors of death for bacteremia in adult from a tertiary-care center from 1981 to 1992.

Material and methods: We randomly included 20% of bacteremic episodes per year.

Results: 47,618 blood-cultures from 19,530 patients, 3428 patients (17.6%) had bacteremia (285/y). From 600 episodes (50/y), 307 were from men, 368 were hospital-acquired (HA), and 88% were monomicrobial. Diabetes mellitus was seen in 103 cases, cirrhosis of the liver in 98, and AIDS in 33, among others. The main microorganisms were: Escherichia coli (177), Klebsiella pneumoniae (53), Enterobacter (50), Salmonella (45) and Pseudomonas aeruginosa (35); coagulase-negative staphylococci (CNS) (116), Staphylococcus aureus (56), and enterococci (22), and Candida (20). CNS decreased during the study (p < 0.01), but Candida spp., Stenotrophomonas maltophilia and enterococci increased (p < 0.01). The crude mortality of the HA bacteremia was 70.8%, and 29.2% in the case of community-acquired, the mortality attributable to HA bacteremia was 41.6%. The main risk factors were: cardiac valvular disease (p < 0.001), stay at the intensive-care unit (p < 0.001), sepsis (p < 0.001), and pneumonia (p < 0.001).

Discussion: Bacteremia had a significant impact on mortality during the study period that has not change despite opportune therapy, Enterococci and candida have emerged as significant pathogens.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia / epidemiology*
  • Bacteremia / microbiology
  • Bacteremia / mortality
  • Candidiasis / epidemiology
  • Comorbidity
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Enterobacteriaceae Infections / epidemiology
  • Female
  • Fungemia / epidemiology
  • Fungemia / microbiology
  • Fungemia / mortality
  • Hospitals, Public / statistics & numerical data
  • Humans
  • Incidence
  • Life Tables
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Morbidity / trends
  • Risk Factors
  • Staphylococcal Infections / epidemiology
  • Survival Analysis
  • Urban Health / statistics & numerical data