[Analysis of critically ill patients with bacteremia]

To study the epidemiology of bacteremia of critically ill patients and the mortality associated with bacteremia and risk factors for death in an intensive care unit.

75 patients with 116 episodes of bacteremia were retrospectively studied.

The mortality rate of the patients was 43%. Staphylococci (29%), Enterococci (12%), Class I inducible beta-lactamase-producing Enterobacter (12%), extensive spectrum beta-lactamase-producing Enterobacter (10%) were the most common pathogens, among which gram-positive organisms constitute a major part. The most commonly affected organs were respiratory (77%), hepatic (53%), circulatory (53%), gastrointestinal (50%), renal (47%), central nervous (36%), and hemopoietic systems (27%). Multiple organ failure accounted for 76%. Univariate analysis revealed that the severity of underlying illness, multiple organ failure (MOF), septic shock, hepatic failure, renal failure and infection focus were the risk factors for in-hospital death (P < 0.05). Cox proportional hazard model analysis suggested central nervous system failure, septic shock, hemopoietic failure, hepatic failure and respiratory manipulation significantly affected the survival time of patients with bacteremia (P < 0.05).

Gram-positive organisms are major pathogens of bacteremia in critically ill patients. Antibiotic therapy can not prevent the occurence of bacteremia, nor can it improve the prognosis.