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Bacteraemia in high-risk patients.

K S Seetha1, I Bairy, P G Shivananda

  • 1Department of Microbiology, Kasturba Medical College Hospital, Manipal-576 119.

Indian Journal of Medical Sciences
|March 21, 2003
PubMed
Summary

High-risk patients show high rates of bloodstream infections (bacteraemia), often caused by drug-resistant bacteria like nonfermenter gram-negative bacilli and coagulase-negative staphylococci. Early antibiotic use, including cephalosporins, is recommended for these vulnerable patients.

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Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Hospital Epidemiology

Background:

  • Bloodstream infections (bacteraemia) are a significant concern in high-risk patient populations.
  • Nonfermenter gram-negative bacilli (NFGNB) and coagulase-negative staphylococci (CoNS) are frequently implicated in hospital-acquired infections.
  • Emerging antibiotic resistance, including Multi Drug Resistant (MDR) strains, oxacillin resistant CoNS (OR-CoNS), and vancomycin resistant CoNS (VR-CoNS), complicates treatment.

Purpose of the Study:

  • To investigate the incidence and causative agents of bacteraemia in high-risk patients.
  • To analyze the antibiotic resistance patterns of bacterial isolates from these infections.
  • To provide recommendations for empirical antibiotic therapy in high-risk units.

Main Methods:

  • Retrospective analysis of bacteraemia cases in a high-risk patient cohort.
  • Identification of bacterial pathogens and antimicrobial susceptibility testing.
  • Review of patient data and hospital stay characteristics.

Main Results:

  • High incidence of bacteraemia observed, predominantly caused by NFGNB and CoNS.
  • Detection of rare bacterial causes of bacteraemia, including Moraxella spp., Aeromonas spp., and Flavobacterium meningosepticum.
  • Significant proportion of isolates exhibited Multi Drug Resistance (MDR), alongside prevalent OR-CoNS and emerging VR-CoNS.

Conclusions:

  • Nosocomial infections and invasive procedures contribute to the high rates of bacteraemia and antibiotic resistance.
  • MDR strains, OR-CoNS, and VR-CoNS pose a substantial clinical challenge.
  • Empirical use of common antibiotics combined with cephalosporins is advised for high-risk patients prior to susceptibility results.

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