Incidencia y sobrevida de bacteriemia en un hospital clinico docente en Santiago de Chile

María Gambra, Jeferson Flores, Kathleen Ramírez, Sofía Palma, Pedro Zitko, María Teresa Valenzuela, Carlos Beltrán

Resumen


INCIDENCE AND MORTALITY OF BACTEREMIA IN A PUBLIC HOSPITAL IN SANTIAGO

Background: The incidence of bacteremia has increased over the last decade due to the aging of the population and the wide implementation of invasive nosocomial procedures and wide-spectrum antimicrobial treatments. Aim: To assess the epidemiology of hospital and ambulatory bacteremias in a public hospital in Santiago. Material and methods: A prospective longitudinal cohort study of laboratory-confirmed adult patients with bacteremia was undertaken at a public hospital in Santiago, between June 1, 2007 and April 30, 2008. Demographic, clinical, and laboratory data was collected into a standardized study-specific form. Results: In the study period, 253 cases of true bacteremia were identified, with an incidence of 11 per 1,000 patient discharges (63.6% nosocomial, 36.7% fatal). Only 2/3 of the cohort was alive at day 28 of hospitalization. Variables associated with lower survival were age with a hazard ratio (HR) of 2.31; 95% confidence intervals (CI) 1.42- 3.77); female gender (HR, 1.70; 95% CI 1.06- 2.71); shock (HR, 3.24; 95%CI 2.01- 5.22); and C reactive protein (HR, 2.10; 95% CI 1.17- 3.78). The variable associated with better survival was surgery (HR, 0.43; 95% CI 0.25-0.75). Selective empiric treatment did not improve survival. Conclusions: Besides age and gender, survival can be influenced by modifiable variables such as presence of shock and surgical intervention, which may provide an opportunity to improve outcomes. 

 


Palabras clave


Bacteremia; Epidemiology; Risk factors; Survival