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

• Published in: Medicina intensiva Vol. 35; no. 4; p. 217
• Main Authors: Olaechea, P M, Alvarez-Lerma, F, Palomar, M, Insausti, J, López-Pueyo, M J, Martínez-Pellús, A, Cantón, M L
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.05.2011
• Subjects: Adult; Aged; Bacteremia - epidemiology; Bacteremia - microbiology; Bacteremia - prevention & control; Case-Control Studies; Catheter-Related Infections - epidemiology; Catheter-Related Infections - microbiology; Catheter-Related Infections - prevention & control; Coagulase; Comorbidity; Critical Illness - epidemiology; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - prevention & control; Female; Fungemia - epidemiology; Gram-Negative Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - epidemiology; Hospital Mortality; Humans; Intensive Care Units - statistics & numerical data; Length of Stay - statistics & numerical data; Male; Middle Aged; Prevalence; Registries; Spain - epidemiology; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal Infections - prevention & control; Spain
• ISSN: 1578-6749
• DOI: 10.1016/j.medin.2010.09.002

To 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. We 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. 167 Spanish Intensive Care Units. Patients admitted to ICU for more than 24 hours. 2,252 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). Crude 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.