Risk factors for mortality and multiresistant bacteria in bloodstream infections acquired in a private hospital intensive care unit

Results Sixty-six different patients, median age 69 years (25-87). Most common origins were central catheter in 22 (31%), lung in 15 (21%) and abdomen in 10 (14%). Gram-negative bacteria alone caused 32 cases (46%, Pseudomonas and Enterobacter were predominant, with 15 cases of MRB), Gram-positive 29 (41%, coagulase-negative staphylococci was the most common), fungi in 9% and mixed origin in 4%. 36 patients (55%) had been previously treated with broad spectrum antibiotics; 40 patients (61%) were under mechanical ventilation, 52% were surgical, 23% with parenteral nutrition and 12% under renal replacement therapy. 36% of patients suffered from shock in the first 48 h of admission in ICU and 30% had neoplasm or other inmunosupresive situation at the admission. 14% of episodes had another previous infection caused by the same bacteria. In 26% of cases clinical manifestation of bacteremia was septic shock. The presence of MRB had significant association with pulmonary origin (OR 4.8; CI 95% 1.3 17; p = 0.02), mechanical ventilation (OR 4.7; CI 95% 1.2 18.5; p = 0.03) and a previous infection by the same germ (OR 11.7; CI 95% 2.6 53; p < 0.01). Previous broad spectrum antibiotic therapy was related but was not significant. Hospital mortality was 27%, we found association with previous treatment with piperacilin-tazobactam (OR 3.7; CI 95% 1.1 12.9; p = 0.04); other factors such as parenteral nutrition and septic shock complicated bacteremia did not reach statistical signification.