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Gram-negative bacteremia in non-neutropenic patients: A 3-year review

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Summary

The causative organisms, clinical manifestations, factors influencing prognosis, and other epidemiological characteristics of 81 episodes of bacteremia due to gram-negative organisms, in non-neutropenic patients, were studied retrospectively during a 3-year period (1992–1994) at the Department of Internal Medicine of the University Hospital of Heraklion, Crete, Greece. The gram-negative bacteremia incidence was 2% and the overall mortality 12%. All 81 patients had fever;Escherichia coli was the most frequent organism isolated (from 47 patients −58%) and was associated with shock (9/47), disseminated intravascular coagulation (DIC) (8/47), anuria (5/47), adult respiratory distress syndrome (ARDS) (3/47), and pneumonia (1/47). Other less frequent gram-negative microorganisms wereKlebsiella spp. (ten patients; 12%),Pseudomonas spp. (7; 7%),Salmonella spp. (5; 6%),Enterobacter spp. (5; 6%),Proteus spp. (3; 3.4%),Stenotrophomonas spp. (3; 3.4%), andAcinetobacter spp. (1; 1.2%). ARDS, shock, DIC, anuria, presence of central venous catheter, urinary catheter, unknown origin of infection and inappropriate treatment were significantly associated with a higher death rate. Early initiation of appropriate therapy was the most important intervention that favorably affected the outcome of gram-negative bacteremias in this patient population.

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Authors and Affiliations

  1. Dept. of Internal Medicine, University of Crete, Div. of Medicine, Haraklion, P. O. Box 1393, GR-71110, Crete, Greence

    A. Gikas M. D., G. Samonis M. D., J. Papadakis M. D., D. Kofteridis M. D. & N. Tsaparas M. D.

  2. Dept. of Clinical Bacteriology, Parasitology and Geographical Medicine, University of Crete, Div. of Medicine, Heraklion, P. O. Box 1352, GR-71110, Crete, Greence

    A. Christidou M. D. & Y. Tselentis M.D.

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  1. A. Gikas M. D.
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  2. G. Samonis M. D.
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  3. A. Christidou M. D.
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  4. J. Papadakis M. D.
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  5. D. Kofteridis M. D.
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  6. Y. Tselentis M.D.
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Gikas, A., Samonis, G., Christidou, A. et al. Gram-negative bacteremia in non-neutropenic patients: A 3-year review. Infection 26, 155–159 (1998). https://doi.org/10.1007/BF02771841

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  • DOI: https://doi.org/10.1007/BF02771841

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