• Medicina intensiva · May 2011

    Comparative Study

    [Impact of primary and intravascular catheter-related bacteremia due to coagulase-negative staphylococci in critically ill patients].

    • P M Olaechea, F Alvarez-Lerma, M Palomar, J Insausti, M J López-Pueyo, A Martínez-Pellús, M L Cantón, and Grupo ENVIN-HELICS.
    • Servicio de Medicina Intensiva, Hospital de Galdakao-Usansolo, Vizcaya, España. PEDROMARIA.OLAECHEAASTIGARRAG@osakidetza.net
    • Med Intensiva. 2011 May 1;35(4):217-25.

    ObjectiveTo study the impact of coagulase-negative staphylococcal (CNS) primary and intravascular catheter-related bloodstream infection (PBSI/CRBSI) on mortality and morbidity in critically-ill patients.DesignWe performed a double analysis using data from the ENVIN-HELICS registry data (years 1997 to 2008): 1) We studied the clinical characteristics and outcomes of patients with CNS-induced PBSI/CRBSI and compared them with those of patients with PBSI/CRBSI caused by other pathogens; and 2) We analyzed the impact of CNS-induced PBSI/CRBSI using a case-control design (1:4) in patients without other nosocomial infections.Setting167 Spanish Intensive Care Units.PatientsPatients admitted to ICU for more than 24 hours.Results2,252 patients developed PBSI/CRBSI, of which 1,133 were caused by CNS. 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<.001).ConclusionCrude 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.Copyright © 2010 Elsevier España, S.L. y SEMICYUC. All rights reserved.

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