Outcome, diagnosis, and microbiological profile comparison of community‐ and hospital‐acquired bacteremia: A retrospective cohort study

Abstract

Abstract Background Although bacteremia is one of the most pressing situation in the field of hospital medicine, little is known about the differences between community‐ and hospital‐acquired bacteremia (CAB and HAB, respectively). Methods Objective is to know the epidemiologic characteristics of CAB and HAB. Study design is a single‐center retrospective cohort study. Participants were all patients over the age of 16 years who were blood cultures positive at single acute care hospital from April 2013 to March 2018. HAB was defined as positive culture acquired at least 48 h after admission or blood culture‐positive patients transferred from other hospital. The primary outcome was 30 day mortality, and the secondary outcome was 1 year mortality. We compared the primary and secondary outcomes between HAB and CAB using logistic regression analyses. Results There were 325 participants in this study. The number of patients with CAB was 189 (58.1%). HAB was associated with a higher 30 day mortality rate than CAB (n = 31, 22.8% vs. n = 9, 4.8%, adjusted odds ratio (AOR) 2.60; 95% confidence interval (CI) 1.04–6.53, p < 0.05). In the secondary outcome, HAB was also associated with a higher 1 year mortality rate (n = 61/110, 55.5% vs. n = 32/143, 22.4%, AOR 2.27; 95% CI: 1.12–4.58). Conclusions Our study showed that HAB was associated with higher mortality than CAB in 30 day mortality and in 1 yr mortality. Thus, we confirmed that HAB is distinct from CAB concerning the differences of outcomes.

Keywords

• bacteremia
• community‐acquired bacteremia
• empiric therapy
• hospital‐acquired bacteremia
• infectious disease
• sepsis