Community – Acquired Bacteremia in Srisaket Hospital a 1- Year Prospective Study
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Over a one – year prospective study of community – acquired bacteremia in Srisaket Hospital revealed 261 patients with bacteremia. The overall incidence and mortality were 6.5/1000 admissions and 39.5 percent, respectively. 152 patients (64.7 percent) with bacteremia were community – acquired infection, of which 89 patients (58.6 percent) were mere males and 63 patients (44.4 percent) were females. The mean age was 51.9 years (range 15-90 years). The statistical difference of mortality in relation to sex or age was not significance. In 148 patients (98 percent) with community – acquired bacteremia a single organism was isolated, most commonly Escherichia coli (28.9 percent),Staphylococcus aureus (17.1 percent),Burkholderia pseudomallei (15.8 percent) and Klebsiella species (15.1 percent). Mortality rate directly related to bacteremia was highest in burkholderia pseudomallei infection (4.2 percent) as compared to other organisms but there was no statistical significance. The most common source of infection was the respiratory system (22.4 percent), followed by the urinary system (13.2 percent) hepatobiliary system (13.2 percent). In nearly 33 percent of cases, the primary site of infection was unknown. Mortality was significantly higher in patients with respiratory tract infection (69.7 percent; P0.001). Three obvious clinical variables predicting the mortality included shock (P0.00001), Glasgow Coma Scale below 9 (15 in totals) (P 0.004) and serum lactate level higher than 6.4 mEq/ L(p0.004). Furthermore, the mortality was not related to the underlying disease or antibiotic treatment
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