• Postgrad Med J · Nov 2011

    Mortality and associated risk factors in consecutive patients admitted to a UK NHS trust with community acquired bacteraemia.

    • Luke Hounsom, Kate Grayson, and Mark Melzer.
    • Department of Microbiology, Barking, Havering & Redbridge University Hospitals NHS Trust, Queen's Hospital, Rom Valley Way, Romford, Essex UK.
    • Postgrad Med J. 2011 Nov 1; 87 (1033): 757-62.

    PurposeWithin the UK, there is lack of contemporary data on clinical outcomes in patients admitted to hospital with severe community acquired infection. The purpose of this study was to determine outcomes and risk factors associated with mortality in consecutive patients admitted to a UK NHS trust with community acquired infections that cause bacteraemia.MethodsFrom September 2007 to August 2008, demographic, clinical and microbiological data were collected on patients with laboratory confirmed bacteraemia. Multivariate logistic regression was used to determine the association between predicted variables and likelihood of death.Results686 bacteraemic episodes occurred in 681 patients. The most common sites of infection were non-catheter associated urinary tract infections (140, 20.4%) and biliary tract infections (62, 9.1%). The most common organisms were Escherichia coli (238, 34.7%), Staphylococcus aureus (84, 12.2%) and Streptococcus pneumoniae (40, 5.8%). Of the E coli infections, extended spectrum β-lactamase (ESBL) producers accounted for 21/238 (8.8%), and of the S aureus infections, methicillin resistant S aureus (MRSA) accounted for 14/84 (16.7%). 124 (18.2%, 95% CI 15.3% to 21.1%) people died within 7 days and 170 (25.0%, 95% CI 21.7% to 28.2%) within 30 days. Age (OR 2.17, 95% CI 1.54 to 3.06), Charlson comorbidity index (OR 1.21, 95% CI 1.10 to 1.34), and Pitt score (OR 1.49, 95% CI 1.32 to 1.67) were highly significantly associated with 30 day mortality (p<0.001). Delay in appropriate antibiotic treatment (OR 1.35, 95% CI 1.05 to 1.75) and an undefined site of infection (OR 2.05, 95% CI 1.19 to 3.53) were less significantly associated with 30 day mortality (p<0.05).ConclusionThe 30 day mortality rate in consecutive patients with community acquired bacteraemic infection was 25.0%. These figures could be used as performance indicators to compare outcomes in different UK NHS trusts. With the exception of delay in appropriate antibiotic treatment, predictors of mortality at 30 days were non-modifiable.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…