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Journal of Korean medical science : JKMS v.25 no.7 = no.140, 2010년, pp.992 - 998   SCI SCIE SCOPUS
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Bloodstream Infections and Clinical Significance of Healthcare-associated Bacteremia: A Multicenter Surveillance Study in Korean Hospitals

Son, Jun Seong    (Division of Infectious Diseases, East-West Neo Medical Center, Kyunghee University School of Medicine, Seoul, Korea.   ); Song, Jae-Hoon    (Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.   ); Ko, Kwan Soo    (Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Seoul, Korea.   ); Yeom, Joon Sup    (Division of Infectious Diseases, Kangbuk Samung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.   ); Ki, Hyun Kyun    (Division of Infectious Diseases, Konkuk University Hospital, Seoul, Korea.   ); Kim, Shin-Woo    (Division of Infectious Diseases, Kyungpook National University Hospital, Daegu, Korea.   ); Chang, Hyun-Ha    (Division of Infectious Diseases, Kyungpook National University Hospital, Daegu, Korea.   ); Ryu, Seong Yeol    (Division of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Korea.   ); Kim, Yeon-Sook    (Division of Infectious Diseases, Chungnam National University Hospital, Daejeon, Korea.   ); Jung, Sook-In    (Division of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea.   ); Shin, Sang Yop    (Division of Inf  ); Oh, Hee Bok   Lee, Yeong Seon   Chung, Doo Ryeon   Lee, Nam Yong   Peck, Kyong Ran  
  • 초록

    Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. Escherichia coli was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, Staphylococcus aureus (15.2%), coagulase-negative Staphylococcus (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment.


  • 주제어

    Bloodstream infection .   Bacteremia .   Community-acquired .   Hospital-acquired .   Healthcare-associated.  

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