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  • Title: Gram-negative intravascular catheter-related bacteremia in patients with spinal cord injury.
    Author: Hussain R, Cevallos ME, Darouiche RO, Trautner BW.
    Journal: Arch Phys Med Rehabil; 2008 Feb; 89(2):339-42. PubMed ID: 18226660.
    Abstract:
    OBJECTIVE: To determine whether the prevalence of gram-negative catheter-related bloodstream infection (CRBSI) is higher in patients with spinal cord injury (SCI) than in patients without SCI. DESIGN: Retrospective chart review from August 1998 to August 2006. SETTING: A Veterans Affairs medical center, which serves as a tertiary care medical center to over 500 veterans with SCI and is the primary source of health care for veterans in southeast Texas. PARTICIPANTS: All hospitalized patients who had an International Classification of Diseases, Ninth Revision, code for bacteremia associated with their hospital stay. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The proportion of CRBSI caused by gram-negative organisms in the SCI patients to the proportion of CRBSI caused by gram-negative organisms in the non-SCI patients. RESULTS: Eight (42%) of 19 episodes of CRBSI in the SCI were caused by a gram-negative organism as compared with 4 (11%) of 36 infections in the non-SCI group (P<.01). Factors associated with having a gram-negative organism rather than a gram-positive organism as the causative agent of CRBSI were SCI, femoral catheter site, prolonged hospitalization, decubitus ulcer, and urinary catheter. CONCLUSIONS: In our medical center, patients with SCI who develop CRBSI are more likely to have an infection with a gram-negative organism than are patients without SCI. This knowledge may guide initial empirical therapy of suspected bloodstream infection.
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