AUTHOR=Yokota Paula Kiyomi Onaga , Marra Alexandre Rodrigues , Belucci Talita Rantin , Victor Elivane da Silva , Santos Oscar Fernando Pavão dos , Edmond Michael B. 

TITLE=Outcomes and Predictive Factors Associated with Adequacy of Antimicrobial Therapy in Patients with Central Line-Associated Bloodstream Infection

JOURNAL=Frontiers in Public Health

VOLUME=4

YEAR=2016

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2016.00284

DOI=10.3389/fpubh.2016.00284

ISSN=2296-2565

ABSTRACT=<sec id="ST1"><title>Background</title><p>Central venous catheters are significant risk factors for bloodstream infection (BSI), which are directly associated with increased morbidity and mortality.</p></sec><sec id="ST2"><title>Methods</title><p>This study was a retrospective cohort study for the time period of July 2011–June 2014 in patients with central line-associated bloodstream infection (CLABSI) to determine the microbiological profile and antimicrobial adequacy of patients with CLABSI in a tertiary hospital.</p></sec><sec id="ST3"><title>Results</title><p>One hundred and twenty-one CLABSI cases were identified. Ninety-two percent (<italic>n</italic> = 111) of patients had monomicrobial BSI. Gram-negative bacteria were the most prevalent (49%, <italic>n</italic> = 63), with <italic>Klebsiella</italic> spp. predominating (30%, <italic>n</italic> = 19). Among the Gram-positive bacteria (<italic>n</italic> = 43, 33%), coagulase-negative staphylococci was the major pathogen (58%, <italic>n</italic> = 25), and all isolates were methicillin resistant. Antimicrobial therapy was assessed as adequate in 81% (<italic>n</italic> = 98) of cases. In-hospital mortality was 36% (<italic>n</italic> = 43 cases).</p></sec><sec id="ST4"><title>Conclusion</title><p>Our CLABSI patients had a high mortality, although antimicrobial therapy was appropriate. Gram-negative bacteria were responsible for almost half of the cases and there was a high rate of bacteria resistance to extended-spectrum antibiotics.</p></sec>