Microbiology, time course and clinical characteristics of infection in critically ill patients receiving packed red blood cell transfusion
Background and Objectives Packed red blood cell transfusion has been associated with increased infection in a variety of critically ill patient populations. We evaluated the microbiology and time course of infection in transfused patients in the intensive care unit (ICU) as no data exist on these p...
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Published in | Vox sanguinis Vol. 97; no. 4; pp. 294 - 302 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
01.11.2009
S. Karger AG |
Subjects | |
Online Access | Get full text |
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Summary: | Background and Objectives Packed red blood cell transfusion has been associated with increased infection in a variety of critically ill patient populations. We evaluated the microbiology and time course of infection in transfused patients in the intensive care unit (ICU) as no data exist on these parameters.
Materials and Methods We performed a retrospective review of data for all patients admitted to a 24‐bed medical‐surgical ICU at Cooper University Hospital from July 2003 to September 2006 and entered in the Project Impact database.
Results A total of 2432 patients were admitted during the study period, of which 609 underwent transfusion. Transfused patients were more likely to develop a nosocomial infection (10·5% vs. 4·9%, P < 0·001). ICU and hospital length of stay were longer in the transfused group (P < 0·001 for both). Mortality was also greater (13·1% vs. 8·7%, P = 0·001). Transfused patients had a shorter time from hospital admission to first infection (P < 0·001) and ICU admission to first infection (P < 0·001). Multivariate analysis confirmed transfusion as an independent risk factor for infection, mortality, hospital and ICU length of stay. Methicillin‐resistant Staphylococcus aureus, vancomycin‐resistant enterococcus and Acinetobacter occurred more often in transfused patients. Acinetobacter accounted for a disproportionate share of infections among transfused patients (P < 0·001).
Conclusions Transfused ICU patients have a higher incidence of nosocomial infection and worse outcomes. Transfused patients had a shorter onset of infection. Acinetobacter infection appears to be particularly common among these patients. Further investigation is merited to better elucidate the mechanism for these findings and their therapeutic and clinical implications. |
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Bibliography: | ark:/67375/WNG-0X6P0GW9-9 istex:F3FCBEEB891081EDCCC92C558D7CF479DA9E7170 ArticleID:VOX1134 Author's contribution: JSR, CS, RD, JEP and DRG conceived and designed the study. CS and RD performed the data collection. JSR, BM and DRG performed the statistical analysis. JSR, CS, BM, JEP and DRG drafted and edited the manuscript. Competing interests The authors declare that they have no conflicts of interest or financial interests concerning any aspect of this research or manuscript. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0042-9007 1423-0410 |
DOI: | 10.1111/j.1423-0410.2009.01134.x |