Impact of primary and intravascular catheter-related bacteremia due to coagulase-negative staphylococci in critically ill patients
Impacto de la bacteriemia primaria y relacionada con catéter intravascular causada por Staphylococcus coagulasa negativo en pacientes críticos
P.M. Olaecheaa,
, F. Álvarez-Lermab, M. Palomarc, J. Insaustid, M.J. López-Pueyoe, A. Martínez-Pellúsf, M.L. Cantóng, the ENVIN-HELICS Group *
Corresponding author
a Servicio de Medicina Intensiva, Hospital de Galdakao-Usansolo, Vizcaya, Spain
b Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, Spain
c Servicio de Medicina Intensiva, Hospital Vall d’Hebron, Barcelona, Spain
d Servicio de Medicina Intensiva, Hospital de Navarra, Navarra, Spain
e Servicio de Medicina Intensiva, Hospital General Yagüe, Burgos, Spain
f Servicio de Medicina Intensiva, Hospital Virgen de la Arrixaca, Murcia, Spain
g Servicio de Medicina Intensiva, Hospital Virgen de la Macarena, Sevilla, Spain
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The associated mortality for PBSI/CRBSI caused by non-CNS pathogens was higher than that of the CNS group (29.8% vs. 25.9%; P = .039) due exclusively to the mortality of patients with candidemia (mortality: 45.9%). In patients without other infections, PBSI/CRBSI caused by CNS (414 patients) is an independent risk factor for a higher than average length of ICU stay (OR: 5.81, 95% CI: 4.31–7.82; P<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001).</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Crude mortality of patients with CNS-induced BPSI/CRBSI is similar to that of patients with BPSI/CRBSI caused by other bacteria, but lower than that of patients with candidemia. Compared to patients without nosocomial infections, CNS-induced PBSI/CRBSI is associated with a significant increase in length of ICU stay</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudiar el impacto en la mortalidad y morbilidad en pacientes críticos de las bacteriemias primarias (BP) y relacionadas con catéteres intravasculares (BRC) causadas por <span class="elsevierStyleItalic">Staphylococcus</span> coagulasa negativo (SCN).</p> <span class="elsevierStyleSectionTitle">Diseño</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Doble análisis con datos del registro ENVIN-HELICS (1997 a 2008): 1) analizar las características clínicas de pacientes con BP/BRC causadas por SCN, comparándolas con las de los pacientes con BP/BRC causadas por otros patógenos; y 2) analizar mediante un estudio casoscontroles (1:4) el impacto de BP/BRC por SCN en pacientes sin otras infecciones nosocomiales frente a pacientes sin ninguna infección nosocomial.</p> <span class="elsevierStyleSectionTitle">Ámbito</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Ciento sesenta y siete UCI españolas.</p> <span class="elsevierStyleSectionTitle">Pacientes</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Pacientes ingresados en UCI más de 24 horas.</p> <span class="elsevierStyleSectionTitle">Intervención</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Ninguna.</p> <span class="elsevierStyleSectionTitle">Variables de interés</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Estancia en UCI y mortalidad.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Dos mil doscientos cincuenta y dos pacientes presentaron BP/BRC de los que 1.133 casos fueron por SCN. La mortalidad de los pacientes con BP/BRC causadas por patógenos distintos de SCN fue superior (29,8% vs. 25,9%; p = 0,039), debido exclusivamente a la mortalidad de pacientes con candidemia (mortalidad: 45,9%). En pacientes sin otras infecciones nosocomiales, la BP/BRC por SCN (414 pacientes) es un factor independiente de riesgo de tener una estancia superior a la media (OR 5,81; IC 95%: 4,31–7,82; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001).</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">La mortalidad cruda de los pacientes que padecieron BP/BRC causada por SCN es similar a la de los pacientes con BP/BRC causada por otras bacterias, pero inferior a la de los pacientes con candidemia. Comparándolo con la estancia en UCI de pacientes sin infecciones nosocomiales, la BP/BRC por SCN es un factor apreciable de prolongación de estancia.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staphylococcus epidermidis and other coagulasenegative Staphylococci" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.L. Archer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Mandell Douglas and Bennett's Principles and Practice of Infectious Diseases" "paginaInicial" => "2092" "paginaFinal" => "2100" "edicion" => "5th" "serieFecha" => "2000" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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| Year/Month | Html | Total | |
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