Características de las infecciones del torrente sanguíneo en pacientes adultos de dos centros de tercer nivel de Córdoba, Argentina

Abstract

Bloodstream infections (BI) are associated with high morbidity and mortality. To determine epidemiological, microbiological and clinical features of community (CA-BI) and nosocomial bloodstream infections (N-BI). Bacteremia and fungemia events were retrospectively analyzed in two third-level hospitals between April 2009 and August 2013. We identified 1150 events of bloodstream infections, 53.2% were CA-BI. Gram negative microorganisms were isolated in 61%. The most frequent pathogens were Escherichia coli in CA-BI and Klebsiella pneumoniae in N-BI. Staphylococcus aureus was the most frequent gram positive organism. The main comorbidities were renal disease (39%) and malignancy (38%). There were 26.8% of primary bloodstream infections, and the main infection foci included respiratory (17.04%) and urinary tract (16.86%). A high percentage of gram-negative bacteria of CA-BI and N-BI were resistance to ampicillin sulbactam (40.2% and 57.5%), cephalothin (36.7% and 46.8%), trimethoprim-sulfamethoxazole 32.8% vs 35.5%) and ciprofloxacin (24.6% and 35.3%). Methicillin-resistant Staphylococcus aureus were more frequently into ITS-IH (31.4% vs 11.8%, p = 0.007). Conclusions: Clinical and epidemiological characteristics of CA-BI and N-BI were similar to those reported by other Latin-American studies. We observed some differences in antimicrobial resistance profiles. We emphasize the importance of local epidemiological surveillance to choose appropriate empirical treatments. Clinical and epidemiological characteristics of CA-BI and N-BI were similar to those reported by other Latin-American studies. We observed some differences in antimicrobial resistance profiles. We emphasize the importance of local epidemiological surveillance to choose appropriate empirical treatments.