期刊
JOURNAL OF INFECTION
卷 57, 期 3, 页码 198-203出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2008.06.018
关键词
bacteremia; mortality; risk factor; incidence
Objectives: To define the incidence, risk factors for acquisition, and outcomes associated with clostridial bacteremia in a large Canadian health region. Methods: Retrospective population-based surveillance for clostridial bacteremia was conducted among all residents of the Calgary Health Region (population 1.2 million) during 2000-2006. Results: One hundred and thirty-eight residents had incident Clostridium species bacteremia (1.8 per 100,000/year); 45 (33%) were nosocomial, 55 (40%) were healthcare-associated community onset, and 38 (28%) were community acquired. Older age and a number of underlying conditions were risk factors for acquiring Clostridium species bacteremia most importantly hemodialysis [relative risk (RR) 212.3; 95% confidence interval (CI) 106.5-385.5], malignancy (RR 40.2; 95% CI 27.6-58.1), and Crohn's disease (RR 11.2; 95% CI 3.0-29.4). Clostridium perfringens was most commonly identified with 58 (42%) isolates followed by Clostridium septicum (19; 14%), Clostridium ramosum (13; 9%), Clostridium clostridiiforme (8; 6%), and Clostridium difficile (7; 5%). Reduced susceptibility to penicillin occurred in 14/135 (10%), to metronidazole in 2/135 (1%), and to clindamycin in 36/135 (27%) isolates. The median length of stay was 12.7 days and 39/130 (30%) patients died in hospital for mortality rate of 0.5 per 100,000/year. Conclusions: Clostridium species bacteremia is associated with a significant burden of illness and hemodialysis and cancer patients are at highest risk. (c) 2008 The British Infection Society. Published by Elsevier Ltd. All rights reserved.
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