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Polymicrobial bacteremia in critically ill patients

J Rello1, E Quintana, B Mirelis

  • 1Department of Intensive Care, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain.

Intensive Care Medicine
|January 1, 1993
PubMed
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Polymicrobial bacteremia (PMB) in critically ill patients is often nosocomial, with Enterobacteriaceae as common pathogens. Improving catheter care may reduce PMB incidence.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Epidemiology

Background:

  • Polymicrobial bacteremia (PMB) is a significant concern in intensive care units (ICUs).
  • Understanding the epidemiology of PMB is crucial for effective management.

Purpose of the Study:

  • To characterize the epidemiology of polymicrobial bacteremia (PMB) in critically ill patients.
  • To identify common pathogens and sources of PMB.

Main Methods:

  • Prospective clinical study conducted in a university medical center.
  • Inclusion of all patients with positive blood cultures in a medical-surgical ICU.
  • Comparison of PMB episodes with monomicrobial bacteremia cases.

Main Results:

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  • PMB accounted for 8.4% of true bacteremia in the ICU.
  • Most PMB cases were nosocomial, primarily associated with postoperative patients without significant immunosuppression.
  • Enterobacteriaceae were the most frequent organisms, with intravascular devices being the most common source.
  • Overall mortality was 7.1%, lower than previously reported.

    • Conclusions:

    • Catheter-related infections are a major source of PMB.
    • Recommendations include catheter replacement and improved catheter maintenance techniques to reduce PMB incidence.