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The increasing importance of polymicrobial bacteremia
Abstract:
Polymicrobial bacteremia increased from 6% in 1970 to 13% in 1975 in patients with bloodstream infections. This type of serious infection most commonly complicated genitourinary (27%) and gastrointestinal (26%) conditions, frequently followed invasive procedures (68%), was more common in hospitalized patients (73%), and was often associated with malignancies (25%) or immunosuppressive or cancer chemotherapy (34%). Although polymicrobial endocarditis was more commonly encountered in recent years, this infection accounted for only 4.5% of patients with multiple organism bacteremias. Gram-negative aerobic bacteria were isolated from 62% and anaerobic bacteria in 39% of patients with polymicrobial bacteremia compared with 37% and 14%, respectively, in patients with monomicrobial bacteremia. In the 88 patients with polymicrobial bacteremia, the mortality was 44.5%, compared with 18.0% in patients with monomicrobial bacteremia.
Insights
Polymicrobial bacteremia, a serious bloodstream infection, doubled between 1970 and 1975. This infection, often linked to invasive procedures and certain medical conditions, had a significantly higher mortality rate compared to monomicrobial bacteremia.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Polymicrobial bacteremia, defined as bloodstream infections involving multiple microorganisms, has been an increasing concern.
- Understanding the risk factors and outcomes associated with polymicrobial bacteremia is crucial for patient management.
Purpose of the Study:
- To investigate the trends, associated conditions, and mortality rates of polymicrobial bacteremia.
- To compare the microbiological characteristics and outcomes of polymicrobial bacteremia with monomicrobial bacteremia.
Main Methods:
- Retrospective analysis of patient data on bloodstream infections.
- Identification and comparison of bacterial isolates (Gram-negative aerobic, anaerobic) in polymicrobial versus monomicrobial cases.
- Statistical analysis of associated conditions, procedures, and mortality rates.
Main Results:
- Polymicrobial bacteremia incidence rose from 6% to 13% between 1970 and 1975.
- Commonly associated with genitourinary (27%) and gastrointestinal (26%) conditions, invasive procedures (68%), hospitalization (73%), malignancies (25%), and chemotherapy (34%).
- Mortality was significantly higher in polymicrobial bacteremia (44.5%) compared to monomicrobial bacteremia (18.0%).
Conclusions:
- Polymicrobial bacteremia is an increasing and serious infection with distinct risk factors.
- The higher mortality associated with polymicrobial bacteremia underscores the need for prompt and effective treatment strategies.
- Gram-negative aerobic and anaerobic bacteria are frequently implicated in polymicrobial bloodstream infections.