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The distinct category of healthcare associated bloodstream infections

Ryan Lenz1, Jenine R Leal, Deirdre L Church

  • 1Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada.

BMC Infectious Diseases
|April 11, 2012
PubMed

Insights

Healthcare-associated community onset bloodstream infections (BSI) differ from community-acquired and hospital-acquired BSI. Recognizing these distinctions is crucial for effective patient care and infection control strategies.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Bloodstream infections (BSI) traditionally categorized as community-acquired (CA) or hospital-acquired (HA).
  • Increasing recognition of a third category: healthcare-associated (HCA) community onset BSI.
  • Need to differentiate HCA-BSI from CA-BSI and HA-BSI.

Purpose of the Study:

  • Compare and contrast epidemiologic, microbiologic, and outcome characteristics of HCA-BSI.
  • Differentiate HCA-BSI from CA-BSI and HA-BSI.

Main Methods:

  • Analysis of first BSI episodes in adults across a Canadian health region (2000-2007).
  • Classification of BSI into HA-BSI, HCA-BSI, or CA-BSI using validated algorithms.
  • Comparison of patient demographics, co-morbidities, microbial etiology, length of stay, and case-fatality rates.

Main Results:

  • HCA-BSI represented 32% of cases, distinct from CA-BSI (40%) and HA-BSI (28%).
  • CA-BSI patients were younger with fewer co-morbidities; HA-BSI had a higher proportion of males.
  • Case-fatality rates were highest for HA-BSI (26%), intermediate for HCA-BSI (19%), and lowest for CA-BSI (10%).
  • Common pathogens included E. coli, S. aureus, and S. pneumoniae, with varying prevalence by acquisition type.

Conclusions:

  • Healthcare-associated community onset infections exhibit unique characteristics.
  • Supports the classification of community onset BSI into separate CA and HCA categories.
  • Highlights the importance of distinguishing BSI origins for targeted interventions.
Abstract

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