Risk Factors for Hospital-acquired Bacteremia
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概要
- 論文の詳細を見る
Objective Bacteremia is one of the most serious health problems associated with high morbidity and mortality. The aim of this study was to identify risk factors for bacteremia in daily medical care to facilitate rapid and accurate clinical decisions about treatment.Patients and Methods We studied 306 inpatients retrospectively. Age, peripheral neutrophil count, C-reactive protein (CRP), platelets, serum total cholesterol, total protein, albumin and cholinesterase were compared in patients with positive- and negative-blood cultures. The associations between blood culture positivity and glucose tolerance, bedridden state, presence of a central venous catheter (CVC) or urinary catheter were examined. On October 14, 2002, strategies for prevention of catheter-related infection were altered in our hospital. We studied the impact of these changes on the risk of bacteremia.Results Sixty-seven patients had positive and 239 had negative blood cultures. Age, neutrophil, platelets, total protein, albumin, and cholinesterase were significantly different between the culture-positive patients and the culture-negative patients. Multivariate analysis showed albumin and platelets as independent predictors. The bedridden state and catheter-inserted states (central venous or urinary) conferred significantly higher positive blood culture rates. Multivariate analysis showed using urinary catheters and indwelling femoral CVCs as independent risk factors. There was no significant difference in the blood culture-positive rate before and after the change in prevention strategies; before the change, 6 of 9 catheter-inserted blood culture-positive cases yielded MRSA, while 4 of 12 cultures yielded Staphylococcus epidermidis after the change.Conclusion Our study highlights the risk factors of bacteremia in vulnerable patients.
- 社団法人 日本内科学会の論文
- 2005-11-01
著者
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KUBO KEISHI
First Department of Internal Medicine, Shinshu University School of Medicine
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Tsuchiya Ayako
Department of Cardiology, St. Marianna University School of Medicine
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Tsuchiya Ayako
Department Of Biosciences And Informatics Faculty Of Science And Technology Keio University
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Tsuchiya Ayako
Department Of Medicine Azumi General Hospital
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Yoshida Takuhiro
Department of Internal Medicine (Neurology and Rheumatology), Shinshu University School of Medicine
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Suzuki Toshiro
Department of Cardiovascular medicine, Nihon University School of Medicine
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Kubo Keishi
First Department Of Internal Medicine Dhinshu University School Of Medicine
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Kubo Keishi
First Department Of Internal Medicine Shinshu University School Of Medicine
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NAKAGAWA Shin-ichi
Department of Applied Chemistry, Faculty of Engineering, Osaka University
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ITO Ken-ichi
Department of Surgery, Shinshu University School of Medicine
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Suzuki Toshiro
Department Of Cardiovascular Medicine Nihon University School Of Medicine
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TSUSHIMA Kenji
Department of Medicine, Azumi General Hospital
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NISHIKAWA Noriko
Department of Medicine, Azumi General Hospital
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SHIRAHATA Kumiko
Department of Medicine, Azumi General Hospital
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KANEKO Kazuma
Department of Medicine, Azumi General Hospital
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KAWAKAMI Hirotaka
Department of Medicine, Azumi General Hospital
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Kaneko Kazuma
Department Of Medicine Azumi General Hospital
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Nishikawa Noriko
Department Of Medicine Azumi General Hospital
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Shirahata Kumiko
Department Of Medicine Azumi General Hospital
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Kawakami Hirotaka
Department Of Medicine Azumi General Hospital
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Tsushima Kenji
Department Of Medicine Azumi General Hospital
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Nakagawa Shin-ichi
Department Of Medicine Azumi General Hospital
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Ito Ken-ichi
Department Of Medicine Azumi General Hospital
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Ito Ken-ichi
Department Of Applied Chemistry Collage Of Engineering University Of Osaka Prefecture
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Yoshida Takuhiro
Department Of Medicine Azumi General Hospital
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Ikeda Shu-ichi
Third Department Of Medicine (neurology And Rheumatology) Shinshu University School Of Medicine
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Kaneko Kazuma
Department of Medicine (Neurology), Shinshu University School of Medicine
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Kaneko Kazuma
Department of Internal Medicine (Neurology and Rheumatology), Shinshu University School of Medicine
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