Bacterial isolates from fatal cases of bloodstream infections at a university hospital in Central, Saudi Arabia.

OBJECTIVES: To describe the microbiology, underlying medical conditions and risk factors contributing to bloodstream infection (BSI) and mortality at a University Hospital in Riyadh, Kingdom of Saudi Arabia.

METHODS: We conducted this study at King Khalid University Hospital, Riyadh, Saudi Arabia, wherein clinical data from patients who died with BSI were collected. All isolates from these patients, from 1 January to 31 December 2004, were identified and antimicrobial susceptibilities were determined.

RESULTS: Of the total 778 patients with BSI, 82 (10.5%) died. Among which 34 (41.5%) were elderly. Half of the patients were from the intensive care units (ICUs). Cardiovascular diseases were the most common diagnosis in 14 (17.1%) patient, followed by malignancy 13 (15.9%), and respiratory diseases 12 (14.6%). Eleven (13.4%) had chronic liver diseases, 6 (7.3%) with renal diseases, sepsis in 5 (6.1%), 4 (4.8%) were post- surgical cases, 3 (3.7%) cases had systemic lupus erythematosus (SLE) and 3 premature infants. The majority of BSI episodes were monobacterial, 71(86.5%). Over 90% of the isolates were hospital acquired. Coagulase negative Staphylococci (CoNS) were the most common organisms representing 25 (30.5%) of all organisms isolated, while Gram positive as a whole represented 50 (61%). Thirty one (38%) were Gram negative bacteria among which Pseudomonas species 6 (7.3%) and Escherichia coli (E. coli) 5 (6%) were the most common. Two (2.4%) of isolates were Candida glabrata.

CONCLUSIONS: Mortality in our patients with BSI was attributed to old age and underlying medical conditions. The risk factors for nosocomial BSI were ICU admission, intravascular catheterization and respiratory tract infections.