Resumo

OLAECHEA, P.M.  e  GRUPO ENVIN-HELICS et al. Impact of primary and intravascular catheter-related bacteremia due to coagulase-negative staphylococci in critically ill patients. Med. Intensiva [online]. 2011, vol.35, n.4, pp.217-225. ISSN 0210-5691.

Objective: 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. Design: 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. Setting: 167 Spanish Intensive Care Units. Patients: Patients admitted to ICU for more than 24hours. Results: 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). Conclusion: 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.

Palavras-chave : Primary bacteremia; Catheter-related bacteremia; Coagulase-negative staphylococcus; Mortality; Morbidity.

        · resumo em Espanhol     · texto em Espanhol     · Espanhol ( pdf )