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versão impressa ISSN 0123-9392


CONTRERAS, María Encarnación Hernández et al. Influencia en la evolución de los pacientes con bacteriemia/candidemia de la participación activa del especialista clínico en Patología Infecciosa. Estudio de una cohorte prospectiva. Infect. [online]. 2017, vol.21, n.1, pp.32-38. ISSN 0123-9392.


Our objective is to evaluate the impact of active care by an Infectious Diseases specialist (IDS) on the outcome of patients with bacteraemia/candidemia.

Patients and methods:

Observational, longitudinal and prospective study of a cohort of patients with bacteraemia/candidemia in a tertiary level hospital (2010-2011). Factors associated with treatment failure (persistent bacteraemia or related death) were analysed (bivariate and multivariate analysis).


A total of 324 episodes of bacteraemia were included, of which surveillance by IDS was implemented in 252 cases (78%). Acquisition was considered nosocomial or healthcare-related in 154 patients (47.5%) and community acquired in 170 (52.5%). More frequent sources of bacteraemia were urinary tract (31%), vascular catheter (14%), intra-abdominal (12%); and unknown (15%); 31.6% had a urinary catheter and 35.4% had a central venous catheter. When blood cultures were processed, 24% of patients had no fever (> 38 °C). Bacteraemia was persistent in 35 patients (11%). Overall mortality was 17.4% and 15% related (therapeutic "failure", 20%). Failure was associated with Pitt ≥ 3 (OR 7.94), McCabe III (OR 3.11), previous use of antibiotics (OR 2.93) and no active care by IDS (OR 2.44).


In our study cohort, severity at presentation, underlying medical conditions, previous antibiotic use and no active Infectious Diseases specialist care

were statistically associated with mortality or microbiological failure.

Palavras-chave : Outcome; Bacteraemia; Infectious disease consultant.

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