Characteristics and Outcomes of Polymicrobial Bloodstream Infections in the Emergency Department: A Matched Case–control Study

• Published in: Academic emergency medicine 2010-10, Vol.17 (10), p.1072-1079
• Main Authors: Lin, Jiun‐Nong, Lai, Chung‐Hsu, Chen, Yen‐Hsu, Chang, Lin‐Li, Lu, Po‐Liang, Tsai, Shang‐Shyue, Lin, Hsing‐Lin, Lin, Hsi‐Hsun
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; bacteremia; Bacteremia - microbiology; Bacteremia - mortality; Bacteremia - physiopathology; Blood-Borne Pathogens - drug effects; Blood-Borne Pathogens - isolation & purification; bloodstream infection; Case management; Case-Control Studies; Clinical medicine; Clinical outcomes; Confidence Intervals; Cross Infection - drug therapy; Cross Infection - microbiology; Cross Infection - mortality; emergency department; Emergency medical care; Emergency Service, Hospital; Female; Gram-Negative Bacterial Infections - diagnosis; Gram-Negative Bacterial Infections - drug therapy; Gram-Negative Bacterial Infections - mortality; Gram-Positive Bacterial Infections - diagnosis; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - mortality; Hospital Mortality - trends; Hospitals, University; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Nosocomial infections; Odds Ratio; polymicrobial infection; Reference Values; Retrospective Studies; Risk Assessment; risk factors; Severity of Illness Index; Sex Factors; Survival Analysis; Taiwan; Treatment Outcome; Veins & arteries
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1111/j.1553-2712.2010.00871.x

Objectives:  Polymicrobial bloodstream infection (BSI) is a critical condition and has been increasingly reported; however, the authors were unable to find an emergency department (ED) patient‐based study in the literature. Methods:  A retrospective matched case–control study with a ratio of 1:3 among patients with polymicrobial BSIs in an ED was conducted. The case group was patients aged > 16 years with polymicrobial BSIs. Patients matched for age and sex with monomicrobial BSIs were sampled as the control group. Demographic information, underlying conditions, microbiologic data, and outcomes were collected for further analysis. Results:  From January 2005 to December 2007, a total of 112 episodes of polymicrobial BSIs among 109 patients were included. Two pathogens were isolated among 87 (77.7%) episodes and three were found among 25 (22.3%) episodes. A history of hospitalization within 90 days was an independent risk factor for polymicrobial BSIs (p = 0.003). Intraabdominal infection (p