2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hoste, E. A. J. Articles by Colardyn, F. A. Search for Related Content PubMed PubMed Citation Articles by Hoste, E. A. J. Articles by Colardyn, F. A.

Effect of Nosocomial Bloodstream Infection on the Outcome of Critically Ill Patients with Acute Renal Failure Treated with Renal Replacement Therapy

Eric A. J. Hoste^*, Stijn I. Blot^*, Norbert H. Lameire, Raymond C. Vanholder, Dirk De Bacquer and Francis A. Colardyn^*

*Intensive Care Unit, Renal Division, and Department of Public Health, Ghent University Hospital, Gent, Belgium.

Correspondence to Dr. Eric Hoste, Intensive Care Unit, 2K12-C, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium. Phone: 32-9-240-27-75; Fax: 32-9-240-49-95; E-mail: erik.hoste{at}UGent.be

ABSTRACT. Critically ill patients with acute renal failure (ARF) treated with renal replacement therapy (RRT) have a high mortality. The authors evaluated a cohort of 704 consecutive intensive care unit (ICU) patients with ARF treated with RRT to determine whether there was an increased incidence of nosocomial bloodstream infection and whether this resulted in a worse outcome. The incidence of nosocomial bloodstream infection was 8.8%, higher than that reported in other series of general ICU patients and also higher than the 3.5% incidence of bloodstream infection in non-ARF patients in the same unit (P < 0.001). There were more bloodstream infections caused by Gram-positive species compared with Gram-negative species or fungi. The distribution over the species was comparable to that reported by others for a general ICU population. The outcome was evaluated with matched cohort analysis. With this technique, patients with bloodstream infection (exposed) were closely matched with patients without bloodstream infection (non-exposed) in a 1:2 ratio. Matching was based on the APACHE II system and length of stay before bloodstream infection (exposure time). Length of stay and mortality were equal in exposed and non-exposed patients. There was also no difference in hospital costs. It can be concluded that critically ill patients with ARF treated with RRT were more susceptible to nosocomial bloodstream infection. Nevertheless, the outcome was not influenced by the presence of bloodstream infection. The high mortality observed in ARF patients could therefore not be attributed to the higher incidence of bloodstream infection.

This article has been cited by other articles:

				J.-J. Parienti, M. Thirion, B. Megarbane, B. Souweine, A. Ouchikhe, A. Polito, J.-M. Forel, S. Marque, B. Misset, N. Airapetian, et al. Femoral vs Jugular Venous Catheterization and Risk of Nosocomial Events in Adults Requiring Acute Renal Replacement Therapy: A Randomized Controlled Trial JAMA, May 28, 2008; 299(20): 2413 - 2422. [Abstract] [Full Text] [PDF]

				S. Dirkes and K. Hodge Continuous Renal Replacement Therapy in the Adult Intensive Care Unit: History and Current Trends Crit. Care Nurse, April 1, 2007; 27(2): 61 - 80. [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673