Nicola M. Zetola, MD
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Zetola NM. Health Care–Associated Bloodstream Infections. Ann Intern Med. 2003;139:232. doi: 10.7326/0003-4819-139-3-200308050-00012
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Published: Ann Intern Med. 2003;139(3):232.
TO THE EDITOR:
In a very ambitious study, Friedman and colleagues (1) suggested that empirical antibiotic therapy should be similar for patients with known or suspected health care–associated bloodstream infections and those with nosocomial bloodstream infections. Although the concept of “community” needs to be reformulated, it is still too early to make such a categorical affirmation.
It is notable that around 50% of the health care–associated and nosocomial bloodstream infections in Friedman and colleagues' study were associated with intravascular devices, producing a high rate of methicillin-resistant Staphylococcus aureus infection in both groups. According to previous studies, patients from the community using vascular devices could be infected by similar pathogens as patients in nosocomial settings, and that could guide empirical therapy (2). However, whether this is also the case for other types of infections remains unclear. Unfortunately, Friedman and colleagues did not discuss whether the causes of bloodstream infections secondary to urinary and gastrointestinal infections and pneumonia, as well as susceptibility of these infections to treatment, also differed among the studied groups.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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