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Commentary

Impact estimates of nosocomial bloodstream infection: looking from a different angle

Dirk Vogelaers1, Marie-Laurence Lambert2 and Stijn Blot1*

Author Affiliations

1 General Internal Medicine and Infectious Diseases, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium

2 Public Health and Surveillance Department, Scientific Institute for Public Health, J. Wytsmanstraat 14, 1050 Brussels, Belgium

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Critical Care 2011, 15:169  doi:10.1186/cc10271


See related research by Prowle et al., http://ccforum.com/content/15/2/R100

Published: 30 June 2011

Abstract

Mortality associated with nosocomial bloodstream infection is multifactorial. Source of infection, etiology, age, underlying disease, acute illness, and appropriateness of antimicrobial therapy all contribute to the final outcome. As such, estimates of mortality attributable to bloodstream infection may differ largely according to the presence or absence of risk factors in distinct patient populations. The adverse effect of nosocomial bloodstream infection for the individual patient is substantial, with about a doubling of the risk of death. Yet, in settings with a high standard of care in terms of infection prevention and control, the occurrence rate of bloodstream infection is relatively low and therefore its impact on overall ICU mortality rather limited. As a consequence, untargeted interventional studies focused on infection prevention should use occurrence rate of infection rather than mortality as outcome variable.