Polymicrobial Bloodstream Infections due to Intra-Abdominal Infections: A Retrospective Analysis of 158 Cases at a Tertiary Care Hospital in Japan

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Polymicrobial bloodstream infections (PBSIs) are associated with a high mortality rate and the intra-abdominal infections are one of the most common sources of PBSIs. However, scant information exists regarding etiology of PBSIs caused by intra-abdominal infections. The aim of this study is to investigate clinical and microbiological characteristics and risk factors contributing to the mortality of PBSIs due to intra-abdominal infections. This is a retrospective cohort study conducted from July 2003 to December 2015 at a tertiary care teaching hospital in Japan. The medical records of adult patients with PBSIs caused by intra-abdominal infections were reviewed. Demographic, clinical, microbiological and outcome data were collected and analyzed to evaluate risk factors associated with the crude 30-day mortality. A total of 158 patients with PBSIs due to intra-abdominal infections were identified. The mean age of the patients was 74.6 (SD: 11.7) years and the crude 30-day mortality was 16.5% (26/158). Cholangitis was the most common source of infections (51.2%), followed by gastrointestinal perforations (37.8%). Based on univariate analysis, gastrointestinal cancers (P = 0.002), solid tumors (P = 0.005) and blood culture isolates including Enterococcus spp. (P = 0.048) were significantly related to mortality. Multivariate analysis using logistic regression model demonstrated that gastrointestinal cancers (odds ratio [OR] =4.05, 95% confidence interval [CI]: 0.49–11.0, P = 0.006) and blood culture isolates including Enterococcus spp. (OR=2.91, 95% CI: 1.02–8.32, P = 0.04) were independently associated with 30-day mortality. Gastrointestinal cancers and blood culture isolates including Enterococcus spp. were associated with the crude 30-day mortality in patients with PBSIs due to intra-abdominal infections. The role of Enterococcus spp. in polymicrobial infections should be further studied. Multivariate analysis of factors associated with 30-day mortality Multivariate analysis of factors associated with 30-day mortality All authors: No reported disclosures.