We performed a prospective study of bloodstream infection to determine factors independently associated with mortality. Between February 1999 and July 2000, 929 consecutive episodes of bloodstream infection at two tertiary care centers were studied. An ICD-9-based Charlson Index was used to adjust for underlying illness. Crude mortality was 24% (14% for community-onset versus 34% for nosocomial...

Mortality associated with nosocomial bloodstream infection is multifactorial. Source of infection, etiology, age, underlying disease, acute illness, and appropriateness of antimicrobial therapy all contribute to the final outcome. As such, estimates of mortality attributable to bloodstream infection may differ largely according to the presence or absence of risk factors in distinct patient popu...

To the Editor—I want to congratulate Bouza et al. [1] for their effort to solve part of the puzzle regarding the diagnosis of catheter-related bloodstream infection without catheter removal in critically ill patients [1]. I would like to make 2 comments to place the results in a broader perspective. The authors excluded arterial and Swan-Ganz catheters from the analysis, notwithstanding the fac...

Catheter-related bloodstream infections (CR-BSIs) are a common, frequently preventable complication of central venous catheterization. CR-BSIs can be prevented by strict attention to insertion and maintenance of central venous catheters and removing unneeded catheters as soon as possible. Antiseptic- or antibiotic-impregnated catheters are also an effective tool to prevent infections. The diagn...

OBJECTIVE To determine whether an education initiative could decrease the rate of catheter-associated bloodstream infection. DESIGN Preintervention and postintervention observational study. SETTING The 19-bed medical ICU in a 1,400-bed university-affiliated urban teaching hospital. PATIENTS Between January 2000 and December 2003, all patients admitted to the medical ICU were surveyed pros...

Multidrug resistance associated with extended-spectrum beta-lactamase (ESBL) and Klebsiella pneumoniae carbapenemase (KPC) among K. pneumoniae is endemic in southern Europe. We retrospectively analyzed the impact of resistance on the appropriateness of empirical therapy and treatment outcomes of K. pneumoniae bloodstream infections (BSIs) during a 2-year period at a 1420-bed tertiary-care teach...