Etiologic organisms as independent predictors of death and morbidity associated with bloodstream infections.

We studied 385 episodes of nosocomial bloodstream infections occurring over 45 months to ascertain if the etiologic organisms were independent predictors of death and morbidity. Independent predictors of death included respiratory failure, oliguria, metabolic acidosis, hypotension, increased age, antibiotic therapy in cases where susceptibility data were unknown, and infection with Pseudomonas aeruginosa. If parameters associated with septic shock were excluded, increased age, severity of disease, and infection with Candida spp. or P. aeruginosa predicted death. Infection with P. aeruginosa, Enterococcus, and Klebsiella pneumoniae predicted hypotension; severity of disease, polymicrobial infection, and infection with Candida spp., Enterococcus, Enterobacter, or Serratia marcescens predicted oliguria; infection with Candida spp. or P. aeruginosa, increased age, severity of disease, and inability to meet hospital financial obligations without assistance predicted respiratory failure. Inability to meet hospital financial obligations without assistance and severity of disease predicted hypothermia; infection with Candida spp. or P. aeruginosa and sex (male) predicted metabolic acidosis.

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