(HealthDay News) — Most bloodstream infections (BSIs) are community-onset and health care-associated, and Staphylococcus aureus is the most common pathogen, according to a study published online March 18 in PLOS ONE.

Deverick J. Anderson, MD, MPH, from the Duke University Medical Center in Durham, NC, and colleagues conducted a multicenter cohort study to describe the epidemiology of BSIs and determine risk factors for inappropriate therapy. From 2003–2006, 1,470 patients were identified as having a BSI in nine community hospitals in the southeastern United States.

The researchers found that 56% of BSIs were community-onset, health care-associated; 29% of patients had community-acquired BSIs and 15% had hospital-onset, health care-associated BSIs. In 23% of cases, the BSIs were due to multidrug-resistant pathogens. The type of infecting organism varied by location of acquisition, with the most common pathogens being Staphylococcus aureus (28%), Escherichia coli (24%), and coagulase-negative staphylococci (10%). Thirty-eight percent of patients were given inappropriate empiric antimicrobial therapy, with the proportion varying by hospital from 21–71% (median, 33%). Factors independently linked to failure to receive appropriate empiric antimicrobial therapy included hospital providing care, assistance with three or more activities of daily living, Charlson score, community-onset, and hospital-onset health care-associated infection.

“Our data suggest that appropriateness of empiric antimicrobial therapy is an important and needed performance metric for physicians and hospital stewardship programs in community hospitals,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical technology industries.

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