Objective: To study the epidemiology of bacteremia of critically ill patients and the mortality associated with bacteremia and risk factors for death in an intensive care unit.
Method: 75 patients with 116 episodes of bacteremia were retrospectively studied.
Results: The mortality rate of the patients was 43%. Staphylococci (29%), Enterococci (12%), Class I inducible beta-lactamase-producing Enterobacter (12%), extensive spectrum beta-lactamase-producing Enterobacter (10%) were the most common pathogens, among which gram-positive organisms constitute a major part. The most commonly affected organs were respiratory (77%), hepatic (53%), circulatory (53%), gastrointestinal (50%), renal (47%), central nervous (36%), and hemopoietic systems (27%). Multiple organ failure accounted for 76%. Univariate analysis revealed that the severity of underlying illness, multiple organ failure (MOF), septic shock, hepatic failure, renal failure and infection focus were the risk factors for in-hospital death (P < 0.05). Cox proportional hazard model analysis suggested central nervous system failure, septic shock, hemopoietic failure, hepatic failure and respiratory manipulation significantly affected the survival time of patients with bacteremia (P < 0.05).
Conclusion: Gram-positive organisms are major pathogens of bacteremia in critically ill patients. Antibiotic therapy can not prevent the occurence of bacteremia, nor can it improve the prognosis.