Logo Image
|Articles|July 2, 2013

Researchers Study Epidemiology, Etiology of Empiric Antimicrobial Treatment in BSI

Bloodstream infections (BSI) still account for significant morbidity and mortality. Rodriguez-Aguirregabiria et al. (2013) describe the epidemiology, etiology, sources and adequacy of empiric antimicrobial treatment in BSI in a retrospective study about all BSI diagnosed during one year. The pattern resistant pathogen study was an EPINE-EPPS project.

Three-hundred-forty patients were included. The median age was 74.5 years [interquartile range (IQR), 58.5-80.5]; acute physiology and chronic health evaluation (APACHE II) score was 13 (IQR, 7-29).

BSI were community-acquired in 56 percent of the cases. The most common source of BSI was urinary tract (48.3 percent ), intra-abdominal (25.6 percent ) and lower respiratory tract infections (18.6 percent ). The most commonly isolated microorganisms were: Escherichia coli, K. pneumoniae, S.aureus (15% oxacilin resistant) and S. pneumoniae. The 8.6 percent  of enterobacteracea family produced extended-spectrum B-lactamasas (ESBLs). Inappropriate treatment was observed in 24.5 percent  and crude mortality rate was 7.7 percent .

Twenty-eight percent of BSI were nosocomial-acquired. The sources of BSI were unknown in 31.7 percent of the cases and catheter-related in 25.7 percent. The secondary sources of BSI were intra-abdominal in 57 percent of the cases. The most common isolated microorganisms were: S.epidermidis and other coagulasa negative, Candida, S. aureus (36 percent oxacilin resistant) and E. coli. 25 percent of enterobacteracea family were ESBLs. The researchers found five BSI caused by Acitetobacter carbapenem (CPM) resistant and 2 BSI by P. aeruginosa CPM resistant. Inappropriate treatment was observed in 52.5 percent and mortality rate was 28.7 percent.

Healthcare-related BSI produced 15.1 percent of the cases. The source of BSI were unknown in 22.6 percent and catheter-related in 11.3 percent. The secondary sources of BSI were urinary tract (60 percent), intra-abdominal (31.4 percent) and respiratory tract infections(8.6 percent). The most common microorganisms were: E.coli, S.aureus (25 percent oxacilin resistant), S.epidermidis and K.pneumoniae. Inappropriate treatment was noticed in 34 percent and mortality rate was 17 percent.

The researchers conclude that knowledge of local epidemiology is important to improve empiric antimicrobial treatment and to reduce mortality-related inappropriate treatment.

Reference: Rodriguez-Aguirregabiria M, Gimenez-Julvez T, et al. Poster presentation P006 at 2nd International Conference on Prevention and Infection Control (ICPIC 2013): Highlights in bloodstream infections: where does the patient acquire the infection? Antimicrobial Resistance and Infection Control 2013, 2(Suppl 1):P6 doi:10.1186/2047-2994-2-S1-P6

 

Related to this article

View more
Infection preventionists in full PPE with children in DRC. (Image credit: author with AI)
Chasing the Bundibugyo Outbreak: How Static Numbers Hide a Moving Epidemic
Nearly 4 months into the DRC's Bundibugyo virus disease outbreak, some indicators suggest transmission may be slowing. But shifting hotspots, treatment-center capacity problems, community deaths, and incomplete surveillance data show why national case totals alone cannot determine whether containment has been achieved.
Read more
Health care workers from the US speaking with other health care workers in DRC. (Image credit: author with AI)
What Outbreak Metrics Can and Cannot Tell Us About the Ebola DRC Response
Is the Ebola outbreak in the DRC getting better? The answer depends on which numbers you examine. Several important indicators are moving in the right direction, including slower case growth and a declining Rₜ. But major gaps remain in contact tracing, testing, community deaths, safe burial coverage, and treatment capacity in some of the hardest-hit areas. ICT takes a deeper look at the latest outbreak data and why the numbers suggest cautious optimism, not victory.
Read more
Dyan Troxell, MSN, RN, director of clinical education at HandCraft Linen Services; J.J. Odom, MBA, CHESP, CMIP, T-CHEST, university director of buildings and grounds for UConn Health and chair-elect of the AHE Board; and Jenna Rivers, MPH, CPH, CIC, manager of infection prevention and control at Moffitt Cancer Center in Tampa, Florida.
At AHE Exchange26: Building Safer, Smarter Reusable Linen Programs
At AHE Exchange 2026, ICT spoke with experts representing commercial laundry services, EVS, and infection prevention about the systems behind a successful reusable linen program. They discuss linen quality, reject rates, unnecessary waste, frontline education, data, PAR levels, infection prevention oversight, and why strong relationships between health care facilities and their laundry providers matter.
Read more
A group of students raising their hands in class during a lecture (Adobe Stock 292282454 by Mediteraneo
Once a Teacher, Always a Teacher: Why Infection Prevention Is Education
How do you celebrate an infection that never happened? That's one of the unusual challenges infection preventionists share with teachers. Both can spend their careers changing outcomes they may never see. Both educate people who don't always want to listen. Both are second-guessed. Both face burnout. And both must somehow keep remembering why they started.
Read more