The Journal of infection
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The Journal of infection · Feb 2011
Multicenter StudyEpidemiology, microbiology and outcomes of healthcare-associated and community-acquired bacteremia: a multicenter cohort study.
Classically, infections have been considered either nosocomial or community-acquired. Healthcare-associated infection represents a new classification intended to capture patients who have infection onset outside the hospital, but who, nonetheless, have interactions with the healthcare system. Regarding bloodstream infection (BSI), little data exist differentiating healthcare-associated bacteremia (HCAB) from community-acquired bacteremia (CAB). We studied the epidemiology and outcomes associated with HCAB. ⋯ HCAB accounts for a substantial proportion of all patients with BSIs admitted to the hospital. HCAB is associated with a higher mortality rate than CAB. Physicians should recognize that HCAB is responsible for many BSIs presenting to the hospital and may represent a distinct clinical group from CAB.
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The Journal of infection · Feb 2011
Multicenter StudyEvaluation of the compliance with the protocol for preventing perinatal hepatitis B infection in Italy.
To evaluate the compliance with the protocol for preventing perinatal hepatitis B infection in Italy, including HBsAg screening of pregnant women and immunization of newborns to infected mothers. ⋯ In this study compliance with the protocol for preventing perinatal hepatitis B was very good. Further efforts are needed to improve adherence to prenatal screening in public hospitals, in hospital located in southern Italy and among foreign women. HBV spread in Italy is progressively declining, also involving immigrant population.
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The Journal of infection · Feb 2011
Impact of discordant empirical therapy on outcome of community-acquired bacteremic acute pyelonephritis.
As ciprofloxacin resistance rate of Escherichia coli causing urinary tract infections has been increasing, concern about inappropriate empirical therapy has been arisen. ⋯ Discordant empirical therapy, mostly with ciprofloxacin, leads to worse early clinical response and longer hospital stay than concordant therapy in community-acquired bacteremic acute pyelonephritis, although it does not affect on overall mortality or clinical cure rate.
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The Journal of infection · Jan 2011
Risk factors and pathogenic significance of severe sepsis and septic shock in 2286 patients with gram-negative bacteremia.
The aim of this study was to identify risk factors for development of severe sepsis or septic shock and to evaluate the clinical impact of severe sepsis on outcome in patients with gram-negative bacteremia (GNB). ⋯ Severe sepsis or septic shock was a common finding in patients with GNB, predicting a higher mortality rate. Renal disease and indwelling urinary catheter were the most important risk factors significantly associated with severe sepsis or septic shock among patients with GNB.