CHICAGO – Intra-abdominal infections are the most common source of hospital-acquired bloodstream infections, results from a year-long, single-center study found.
"With the movement toward reducing all hospital-acquired infections, it is important to find out where to put our efforts," lead investigator Dr. Mohamad G. Fakih said in an interview before a poster session at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy, where the research was presented in poster form.
To better understand the main sources of hospital-acquired bloodstream infections, Dr. Fakih and his associates at the 804-bed St. John Hospital and Medical Center, Detroit, retrospectively evaluated 180 cases of patients with positive blood cultures from 10 adult nonintensive medical-surgical units at the hospital between October 2009 and September of 2010. They collected data on infection source, causative organism, and whether it was hospital-acquired (defined as the emergence of a bloodstream infection greater than 48 hours after admission).
In all, 47 of the cases were considered to be contaminants. That left 133 cases of bloodstream infections: 42 of them had a community-onset and 91 were acquired in the hospital.
Dr. Fakih, medical director of infection prevention and control at the hospital, reported that of the 91 hospital-acquired cases of bloodstream infection, 20 (22%) were related to Staphylococcus aureus, 3 (3.3%) to coagulase-negative staphylococci, 11 (12.1%) to other gram-positive organisms, 25 (27.5%) to gram-negative bacilli, 21 (23.1%) to mixed organisms, 5 (5.5%) to anaerobes, and 6 (6.6%) to Candida species.
As for common sources of hospital-acquired bloodstream infections, 32 (35.2%) were intra-abdominal, 19 (20.9%) were vascular catheter, 11 (12.9%) were urinary tract, and 9 (9.9%) were soft tissue.
Dr. Fakih noted that peripheral intravenous catheters were the source of 42.1% of bloodstream infections that were associated with vascular catheters.
He indicated certain limitations of the study, including its single-center design. Dr. Fakih also encouraged clinicians to cast a wide net when it comes to infection control practices. "Look at what is important in your hospital and not only what is mandated by external agencies or what is now considered to be hospital-acquired conditions," he advised.
The conference was sponsored by the American Society for Microbiology. Dr. Fakih said that he had no relevant financial conflicts to disclose.