tailieunhanh - Báo cáo y học: "Acquired bloodstream infection in the intensive care unit: incidence and attributable mortality"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Acquired bloodstream infection in the intensive care unit: incidence and attributable mortality. | Prowle et al. Critical Care 2011 15 R100 http content 15 2 R100 KS CRITICAL CARE RESEARCH Open Access Acquired bloodstream infection in the intensive care unit incidence and attributable mortality 1 1 1 2 I z- -I- -3 3 John R Prowle Jorge E Echeverri E Valentina Ligabo Norelle Sherry Gopal C Taori Timothy M Crozier XT r z m Z IX I_I 1 I z r R ỉ IX cs V m í r 4 D i z z 1 Z x I I- 1 - 1II5D iiI D I cs r cs 2 D I I z l z D z I I z m z 1 6 Graeme K Hart lony M Korman Barrie C Mayall Paul DR Johnson Rinaldo Bellomo Abstract Introduction To estimate the incidence of intensive care unit ICU -acquired bloodstream infection BSI and its independent effect on hospital mortality. Methods We retrospectively studied acquisition of BSI during admissions of 72 hours to adult ICUs from two university-affiliated hospitals. We obtained demographics illness severity and co-morbidity data from ICU databases and microbiological diagnoses from departmental electronic records. We assessed survival at hospital discharge or at 90 days if still hospitalized. Results We identified 6339 ICU admissions 330 of which were complicated by BSI . Median time to first positive culture was 7 days IQR 5-12 . Overall mortality was in patients with BSI and in those without. Patients who developed BSI had higher illness severity at ICU admission median APACHE III score 79 vs. 68 P . After controlling for illness severity and baseline demographics by Cox proportional-hazard model BSI remained independently associated with risk of death hazard ratio from diagnosis 95 confidence interval P . However only 5 of the deaths in this model could be attributed to acquired-BSI equivalent to an absolute decrease in survival of 1 of the total population. When analyzed by microbiological classification Candida Staphylococcus aureus and gram-negative bacilli infections were independently associated with increased risk of death. In a sub-group analysis .