Abstract
BackgroundBacteraemia is a common cause of morbidity and mortality in patients admitted to hospital. The aim of this study is to analyse the results of a two-year programme for the early optimisation of antibiotic treatment in patients admitted to the Costa del Sol Hospital (Marbella. Spain).MethodsA prospective two-year cohort study was conducted, evaluating all episodes of bacteraemia at the Costa del Sol Hospital. Epidemiological and microbiological characteristics, any modification of the initial antibiotic treatment, prognostic risk stratification, early mortality related to the episode of bacteraemia, and mortality after the seventh day, were included in the analysis.ResultsSeven hundred seventy-three episodes of bacteraemia were treated, 61.6% males and 38.4% females. The mean age was 65.2 years. The condition was most commonly acquired in the community (41.4%). The bacteraemia was most frequently urological in nature (30.5%), and E coli was the microorganism most frequently isolated (31.6%). In 51.1% of the episodes, a modification was made to optimise the treatment. In the first week, 8.2% died from bacteraemia, and 4.5% had died when they were located. The highest rates of death were associated with older patients, nosocomial acquisition, no source, McCabe score rapidly fatal, Charlson index ≥3, Pitt index ≥3 and treatment remained unmodified.ConclusionThe existence of bacteraemia control programmes and teams composed of clinicians who are experienced in the treatment of infectious diseases, can improve the disease outcome by enabling more severe episodes of bacteraemia to be recognised and their empirical treatment optimised.
Highlights
Bacteraemia is a common cause of morbidity and mortality in patients admitted to hospital
The aim of this study is to describe the results achieved by a multidisciplinary early intervention programme for patients with bacteraemia, and its impact on attributable mortality during the first 7 days
Since 2008, the Costa del Sol Hospital (HCS) has employed a multidisciplinary programme for early intervention in patients with positive blood cultures, staffed by clinicians from the infectious disease and microbiology groups [6, 7]
Summary
Bacteraemia is a common cause of morbidity and mortality in patients admitted to hospital. Bacteraemia is a major cause of morbidity and mortality in patients admitted to hospital [1,2,3]. Many of the deaths caused by this infectious process take place in the first few hours following the onset of bacteraemia For this reason, it is crucial to implement measures for diagnosis and treatment as soon as possible [4].It is important to identify the subgroup of patients who are most likely to present a poor prognosis and suffer greater mortality. The aim of this study is to describe the results achieved by a multidisciplinary early intervention programme for patients with bacteraemia, and its impact on attributable mortality during the first 7 days. We aimed to determine risk factors for 7 day mortality
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