Epidemiology of Bacteremic Sepsis in Adults at Pathum Thani Hospital - ระบาดวิทยาของการติดเชื้อแบคทีเรียในกระแสเลือดในผู้ใหญ่ที่โรงพยาบาลปทุมธานี

Abstract

Hemoculture is very important diagnostic test in sepsis which is a common and serious condition.
It can detect bacteremia and fungemia. Epidemiological data has changed due to emerging of
resistant organisms and change of health care services. Retrospective study was conducted in adult
patients admitted to PathumThani hospital with sepsis who had positive hemocultures during January-
June 2011. In 134 cases, there were 27.2 percent contamination rate and 72.8 percent true
infection. According to acquisition of infection, 75.4 percent were classified as community-acquired
infection, 18.7 percent as hospital-acquired infection and 6 percent as health care-associated infection,
respectively. Common sources of infection were respiratory tract, urinary tract and skin and
soft tissue infection whereas unknown source was 22.4 percent. Hospital-acquired infection was
more severe with high mortality. Causative organisms were gram negative bacteria 54.5 percent and
gram positive 45.5 percent, no fungemia was detected. Among these bacteria, gram negative and
gram positive resistant strains were found to be 12.7 percent and 10.4 percent, respectively. In
hospital mortality rate was 50 percent with higher risk of death in older age, hospital-acquired infection,
respiratory tract infection, multisystem dysfunction and inappropriate antibiotic treatment.
Bacteremic sepsis had different clinical features depend on acquisition of infection. Health careassociated
infection was an overlapping condition between community-acquired infection and hospital-
acquired infection so it should not be the same as community-acquired infection. Emerging of
resistant organisms was an important problem. This condition still had high mortality.
Key words: bacteremia, blood stream infection, sepsis.