• Shira Goldman, Oranit Itshaki, Tzippy Shochat, Anat Gafter-Gvili, Dafna Yahav, Bina Rubinovitch, and Daniel Shepshelovich.
• Department of Nephrology and Hypertension, Davidoff Cancer Center, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
• Isr Med Assoc J. 2020 May 1; 22 (5): 279-284.

BackgroundRecent data regarding polymicrobial bacteremia (PMB) are lacking.ObjectivesTo characterize risk factors as well as clinical, microbiological, and prognostic patterns of patients with PMB in a modern hospital setting.MethodsA single center retrospective study including all patients diagnosed with PMB during 2013 was conducted. PMB was defined as two or more organisms cultured from the blood of the same patient within 72 hours. Patients with monomicrobial infections served as controls.ResultsThere were 135 episodes (2% of all bacteremia episodes) of true PMB among 123 patients during the study period. Recent invasive procedures (odds ratio [OR] 3.59, 95% confidence interval [95%CI] 1.41-9.12, P = 0.006) and foreign bodies (OR 1.88, 95%CI 1.06-3.33, P = 0.04) were risk factors for PMB when compared with 79 patients with monomicrobial bacteremia. Central-line-associated infections were the most common infection source among patients with PMB (n=34, 28%). Enterobacteriaceae were the most commonly implicated pathogen (n=95, 77%). Non-fermenting Gram-negative bacilli were significantly more common than previously reported (n=55, 45%). Although crude 30-day mortality was higher (48% vs. 33%) in PMB patients, adjusted mortality was comparable in the two groups.ConclusionsPMB rate in our cohort was considerably lower than in previous reports. Central-line-associated infections were more common than classic PMB sources. Mortality remained high. Strategies for early identification and better care for these patients should be pursued.

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