Bacterial isolates from fatal cases of bloodstream infections at a university hospital in Central, Saudi Arabia

ABSTRACT

To describe the microbiology, underlying medical conditions and risk factors contributing to bloodstream infection [BSI] and mortality at a University Hospital in Riyadh, Kingdom of Saudi Arabia. We conducted this study at King Khalid University Hospital, Riyadh, Saudi Arabia, wherein clinical data from patients who died with BSI were collected. All isolates from these patients, from 1 January to 31 December 2004, were identified and antimicrobial susceptibilities were determined. Of the total 778 patients with BSI, 82 [10.5%] died. Among which 34 [41.5%] were elderly. Half of the patients were from the intensive care units [ICUs]. Cardiovascular diseases were the most common diagnosis in 14 [17.1%] patient, followed by malignancy 13 [15.9%], and respiratory diseases 12 [14.6%]. Eleven [13.4%] had chronic liver diseases, 6 [7.3%] with renal diseases, sepsis in 5 [6.1%], 4 [4.8%] were post- surgical cases, 3 [3.7%] cases had systemic lupus erythematosus [SLE] and 3 premature infants. The majority of BSI episodes were monobacterial, 71[86.5%]. Over 90% of the isolates were hospital acquired. Coagulase negative Staphylococci [CoNS] were the most common organisms representing 25 [30.5%] of all organisms isolated, while Gram positive as a whole represented 50 [61%]. Thirty one [38%] were Gram negative bacteria among which Pseudomonas species 6 [7.3%] and Escherichia coli [E. coli] 5 [6%] were the most common. Two [2.4%] of isolates were Candida glabrata. Mortality in our patients with BSI was attributed to old age and underlying medical conditions. The risk factors for nosocomial BSI were ICU admission, intravascular catheterization and respiratory tract infections