ArticlesCommunity-acquired bacteremia at a teaching versus a nonteaching hospital: Impact of acute severity of illness on 30-day mortality*
Section snippets
Setting
This study was performed at two hospitals in the greater Buffalo, NY, region. The Erie County Medical Center (ECMC) is an urban, public hospital and is a major teaching hospital for the School of Medicine and Biomedical Sciences, State University of New York at Buffalo. It has 400 beds and provides both primary and tertiary care for a diverse patient population. It not only serves the indigent population but also provides tertiary care for the region including a Level I Trauma Unit, a regional
Demographic and clinical characteristics
During 1995, there were 174 episodes of CAB identified among patients admitted to the teaching hospital for an incidence of 12.9 episodes per 1000 admissions and 75 CAB episodes among those admitted to the nonteaching hospital or 11.6 episodes per 1000 admissions. A comparison of clinical characteristics of these two groups is shown in Table 1.Patients at the nonteaching hospital were, on average, older but less acutely ill, as determined by the mean APS APACHE III score on admission, compared
Discussion
In studies published in recent years, CAB has been evaluated in combination with hospital-acquired bacteremia,3, 4, 6, 7, 8, 9, 10, 11, 12 in a specific group of patients (eg, the elderly15 or those with AIDS,16) or due to a specific organism. Few studies have evaluated CAB in the setting of a nonteaching hospital.3, 4, 11 There has been only one study5 published in the past 15 years that has exclusively focused on CAB.5 Our study provides updated information on the epidemiology and outcome of
References (24)
- et al.
The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults
Chest
(1991) - et al.
Staphylococcus aureus bacteremia and recurrent staphylococcal infection in patients with acquired immunodeficiency syndrome and AIDS-related complex
Am J Med
(1988) - et al.
Staphylococcus aureus bacteremia in diabetic patients—endocarditis and mortality
Am J Med
(1982) - et al.
Staphylococcus aureus bacteremia in patients on chronic hemodialysis
Am J Kidney Dis
(1985) - et al.
Trends in infectious diseases mortality in the United States
JAMA
(1996) - et al.
Trends in infectious disease hospitalizations in the United States, 1980-1994
Arch Intern Med
(1998) - et al.
Endemic bacteremia in Columbia, South Carolina
Am J Epidemiol
(1986) - et al.
An analysis of community and hospital-acquired bacteraemia in a large teaching hospital in the United Kingdom
Q J Med
(1987) - et al.
Community-acquired bacteremia: a prospective survey of 239 cases
Q J Med
(1988) - et al.
The causative organisms of septicaemia and their epidemiology
J Antimicrob Chemotherapy
(1990)
A three-year study of positive blood cultures, with emphasis on prognosis
Rev Infect Dis
Septicemia in 980 patients at a university hospital in Berlin: prospective studies during 4 selected years between 1979 and 1989
Clin Infect Dis
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Reprint requests: Joseph M. Mylotte, MD, CIC, Infectious Diseases, Erie County Medical Center, 462 Grider St, Buffalo, NY 14215.