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Morbidity and Mortality Associated with Multiple Episodes of Nosocomial Bloodstream Infection: A Cohort Study

Published online by Cambridge University Press:  21 June 2016

Patti J. Miller*
Affiliation:
Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
Barry M. Farr
Affiliation:
University of Virginia's, State-wide Infection Control Program, Charlottesville, Virginia
*
Research Administrator, Box 173—Department of Medicine, University of Virginia, Charlottesville, VA 22908

Abstract

A retrospective cohort study of patients with multiple nosocomial bloodstream infections (BSIs) compared with patients suffering only one BSI was conducted to assess morbidity and mortality. Three hundred forty-one patients with BSIs were identified, including 33 with multiple BSIs (9.7%). No significant differences existed between patients experiencing one BSI compared to those experiencing multiple BSIs in age, sex, race, severity of underlying disease, hypothermia, hypoxemia, oliguria, metabolic acidosis, or hypotension. Sixteen of 33 (49%) with multiple BSIs died compared with 124 of 308 (40%) with only one BSI (P =0.36), leading to a relative risk of 1.23 for death and an attributable mortality of 9% in those with multiple BSIs.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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References

1. Haley, RW: Managing Hospital Infection Control JOT Cost-Effectiveness. Chicago. American Hospital Publishing Inc, 1985.Google Scholar
2. Leviten, DL, Shulman, ST: Multiple nosocomial infections. Chlin Pediatr. 1980;19:205208.CrossRefGoogle ScholarPubMed
3. Roy, TE, McDonald, S, Patrick, ML, et al: A survey of hospital infection in at pediatric hospital. Part I. Description of hospital, organization of survey, population studied and some general findings. Can Med Assor J. 1962;87:531538.Google Scholar
4. Eickhoff, TC, Brachman, PS, Bennett, JV, et al: Surveillance of nosocomial infections in community hospitals. I. Surveillance methods, effectiveness and initial results. J Infect Dis. 1969;120:305316.CrossRefGoogle ScholarPubMed
5. Gardner, P, Cartle, DG: Infections acquired in a pediatric hospital. J Pediatr 1972;81:12051210.CrossRefGoogle Scholar
6. Rose, R, Hunting, KJ, Townsend, TR, et al: Morbidity/mortality and economics of hospital-acquired blood stream infections: A controlled study. South Med J. 1977;70:12671269.CrossRefGoogle ScholarPubMed
7. Spengler, RF. Greenough, WB III, Stolley, PD: A descriptive study of nosocomial bacteremias at The Johns Hopkins Hospital. 1968-1974. Johns Hopkins Med J. 1978;142(3):7784.Google Scholar
8. McGowan, JE Jr. Barnes, MW, Finland, M: Bacteremia at Boston City Hospital: Occurrence and mortality during 12 selected years (1935-1972) with special reference to hospital acquired group one. J Infect Dis. 1975;132:316335.CrossRefGoogle Scholar
9. Wenzel, RP, Osterman, CA, Hunting, KJ: Hospital-acquired infections: II. Infection rates by site, service and common procedures in a university hospital. Am J Epidemiol. 1976;104:645651.CrossRefGoogle ScholarPubMed
10. McCabe, WR, Jackson, GG: Gram-negative rod bacteremia: I. Etiology and ecology. Arch Intern Med. 1962;110:847855.CrossRefGoogle Scholar
11. McCabe, WR, Jackson, GG: Gram-negative rod bacteremia: Clinical, laboratory, and therapeutic observations. Arch Intern Med. 1962;110:556564.CrossRefGoogle Scholar
12. DuPont, HL, Spink, WW: Infections due to gram-negative organisms: An analysis of 860 patients with bacteremia at the University of Minnesota Medical Center 1958-1966. Medicine. 1969;48:307332.CrossRefGoogle ScholarPubMed
13. Bryant, RF, Hood, AF, Hood, CE, et al: Factors affecting mortality of gram-negative rod hacteremia. Arch Intern Med. 1971;127:120128.CrossRefGoogle Scholar
14. Sladen, A, Acid-Base Balance, Advanced Cardiac Life Support. American Heart Association, 1981. pp 135140.Google Scholar
15. Young, LS, Gram-negative bloodstream infection, in Mandell, GL, Douglas, RG Jr, Bennett, JE (eds): Principles and Practices of Infectious Diseases. New York, John Wiley & Sons, 1985. pp 452475.Google Scholar
16. World Health Organization: International Classification of Diseases, CODE, Clinical Modification. rev 9. Ann Arbor, Mich, Edwards Brothers Inc. 1980.Google Scholar
17. Stampfer, MI Willett, WC. Speizer, FE, et al: Test of the National Death Index. Am J Epidemiol 1984;119:837839.CrossRefGoogle ScholarPubMed
18. Rogot, E, Feinleib, M, Ockay, KA. et al: On the feasibility of linking census samples to the National Death Index for epidentiologic studies: A progress report. Am J Public Health. 1983;73:12651269.CrossRefGoogle Scholar
19. Davis, KB, Fisher, L. Gillespie, MJ, et al: A test of the National Death Index using the coronary artery surgery study (CASS). Controlled Clin Trials. 1985;6:171191.CrossRefGoogle ScholarPubMed
20. Curb, JD. Ford, CE, Pressel, S. et al: Ascertainment of vital status through the National Death Index and the Social Security Administration. Am J Epidemiol. 1985;121:754766.CrossRefGoogle ScholarPubMed
21. Nelson, NA, Van Peenen, PFD: Test of the National Death Index, letter to the editor. Am J Epidemol. 1985;121:626.CrossRefGoogle Scholar
22. Wentworth, DN. Neaton, JD. Rasmussen, WL: An evaluation of the Social Security Administration master beneficiary record tile and the National Death Index in the ascertainment of vital status. Am J Public Health 1983;73:12701274.CrossRefGoogle Scholar
23. MacMahon, B. The National Death Index, letter to the editor. Am J Public Health 1983;73:12471248.CrossRefGoogle Scholar
24. Roi, LD, Flora, JD, Davis, TM, et al: A severity grading chart lit the burned patient. Ann Emerg Med. 1981;10:161163.CrossRefGoogle Scholar
25. Fletcher, RH, Fletcher, SW. Wagner, EH: Risk. Clinical Epidemiology—The Essentials. Baltimore, Williams & Wilkins, 1984. pp 91105.Google Scholar