Reappraisal of Community-Acquired Bacteremia: A Proposal of a New Classification for the Spectrum of Acquisition of Bacteremia

In recent years, dramatic changes in health care systems have shifted much of the care of sick individuals from hospitals to the community. Consequently, infections traditionally classified as community-acquired or hospital-acquired infections cannot now be readily classified into either category. W...

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Bibliographic Details
Published in:Clinical infectious diseases 2002-06, Vol.34 (11), p.1431-1439
Main Authors: Yardena, Siegman-Igra, Boaz, Fourer, Ruth, Orni-Wasserlauf, Yoav, Golan, Aliza, Noy, David, Schwartz, Michael, Giladi
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antimicrobials
Bacteremia
Bacteremia - classification
Bacteremia - epidemiology
Bacteremia - microbiology
Bacteremia - mortality
Bacterial diseases
Bacterial sepsis
Biological and medical sciences
Blood
Chemotherapy
Community acquired infections
Community-Acquired Infections - classification
Community-Acquired Infections - epidemiology
Community-Acquired Infections - microbiology
Community-Acquired Infections - mortality
Escherichia coli - drug effects
Female
Hospital admissions
Hospitalization
Human bacterial diseases
Humans
Infections
Infectious diseases
Major Articles
Male
Medical sciences
Microbial Sensitivity Tests
Microorganisms
Nursing homes
Staphylococcus aureus - drug effects
Streptococcus pneumoniae - drug effects
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Summary:In recent years, dramatic changes in health care systems have shifted much of the care of sick individuals from hospitals to the community. Consequently, infections traditionally classified as community-acquired or hospital-acquired infections cannot now be readily classified into either category. We thus propose a new classification based on a wider spectrum of acquisition. A total of 1028 episodes of bloodstream infection (BSI) were divided into 5 categories: true community-acquired infections (370 episodes [36%]), infections in recently discharged patients (110 [11%]), infections associated with invasive procedures performed just before or at the time of admission (56 [5%]), infections in patients admitted from nursing homes (68 [7%]), and hospital-acquired infections (424 [41%]). Thus, 234 (39%) of the 604 bloodstream infections traditionally defined as community acquired were reclassified into 3 newly defined groups, each of which has distinct epidemiologic, clinical, and bacteriologic characteristics, as well as distinct antimicrobial susceptibility profiles. There is a conceptual and practical need for such a new classification.
ISSN:1058-4838
1537-6591
DOI:10.1086/339809