Comparison of community and hospital-acquired bacteremia in a Greek university hospital: One year experience

Abstract

I. Starakis1*, E. E. Mazokopakis1, D. Siagris1, Iro Tsantoula2and C. A. Gogos2

All bacteraemic cases, from August 2006 to September 2007 were identified by reviewing all positive blood culture results from the microbiology department of our hospital. One thousand three hundred and sixty six cases were detected in 1336 patients. The rate of true bacteremia which was 13.1 and 10.7% of cultures were contaminated. Of the 1366 episodes of bloodstream infection, 55.3% were community-acquired and 44.7% were health-care associated. Gram-positive bacteria prevailed (58.5%), followed by gram negative bacilli (38.5%). Polymicrobial bacteremia was detected in 2.2% of cases. Coagulase-negative staphylococci (CoNS) were the leading cause (550/1366 = 40.3%), whilst enterococci, Staphylococcus aureus and Streptococci represented 8, 6.4 and 3.8% respectively. Pseudomonas aeruginosa was the commonest gram -negative isolate (155/1366 = 11.3%), followed by Escherichia coli (8.2%) and Acinetobacter sp. (7.3%) . Fungi were isolated in the 3% of the isolates and Candida albicans accounted for the 70.7% of them. Fatal outcome due to bloodstream infections was 15.3% and 5.7% in hospital (HA) and community-acquired (CA) episodes, respectively (P < 0.0005) .The highest mortality occurred in patients with bacteremia due to Acinetobacter (41%) in HA episodes, and in patients with bacteremia due to S. aureus (34.0%) in CA incidents.