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Isr Med Assoc J ; 16(7): 418-22, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25167686

RESUMEN

BACKGROUND: The role of routine active surveillance cultures (ASCs) in predicting consequent bloodstream infections is unclear. OBJECTIVES: To determine prospectively whether routine screening ASCs obtained on admission to the intensive care unit (ICU) can predict the causative agent of subsequent bloodstream infections. METHODS: We prospectively studied a cohort of 100 mechanically ventilated patients admitted consecutively to a 16-bed ICU. On admission, ASCs were obtained from four sites: skin cultures (swabs) from the axillary region, rectal swabs, nasal swabs, and deep tracheal aspirates. Thereafter, cultures were obtained from all four sites daily for the next 5 days of the ICU stay. RESULTS: Of the 100 recruited patients 31 (31%) had culture-proven bacteremia; the median time to development of bacteremia was 5 days (range 1-18). Patients with bacteremia had a longer median ICU stay than patients without bacteremia: 14 days (range 2-45) vs. 5 days (1-41) (P < 0.001). ICU and 28 day mortality were similar in patients with and without bacteremia. Most ASCs grew multiple organisms. However, there was no association between pathogens growing on ASCs and eventual development of bacteremia. CONCLUSIONS: ASCs obtained on ICU admission did not identify the causative agents of most subsequent bacteremia events. Therefore, bloodstream infections could not be related to ASCs.


Asunto(s)
Bacteriemia/microbiología , Enfermedad Crítica , Infección Hospitalaria/microbiología , Unidades de Cuidados Intensivos , APACHE , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/epidemiología , Bacteriemia/terapia , Comorbilidad , Infección Hospitalaria/epidemiología , Infección Hospitalaria/terapia , Femenino , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Estudios Prospectivos , Respiración Artificial , Factores de Riesgo
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