Exposure to Antibiotics and Incidence of Bacteraemia Caused by Resistant Bacteria

Study Overview
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Brief Summary
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The primary objective of the study is to identify the risk factors of community-acquired bacteremia to resistant bacteria. As the secondary objectives, the study aims to describe the episodes of epidemiology of bacteremia (community-acquired and nosocomial) with inpatient patients in APHP. to research a potential correlation between the incidence of community-acquired bacteremia of studied germs and the evolution of antibiotics consumption in general population in Île de France region. to distinguish three categories of community-acquired bacteremia: real community-acquired infections, infections beginning in community (patients discharged a community care center within 3 months), the nosocomial infections (patients discharged a health center within 7 jours). Describe the epidemiology of resistance and the differential impact of individual exposure to antibiotics in these three categories. to identify, according to pathogens, a temporal threshold from which a prior stay in a health center or HAD would impact on the occurrence of a community-acquired bacteremia with a resistant bacterium. to describe prospectively for follow-up of 1 year for hospitalized patients for a community-acquired or nosocomial bacteremia: mortality at one month and 3 months, re-hospitalization for an infectious episode and isolated bacteria during this later episode.

Detailed Description
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The investigators will study in particularly individual exposure to antibiotics: exposure in 3 months ou in 12 months, cumulative exposure, hospital- and community-acquired exposure, etc.

Official Title
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Exposure to Antibiotics and Incidence of Bacteraemia Caused by Resistant Bacteria

Conditions
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Bacteremia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: For bacteraemia cohort: All inpatient patients in a hospital of APHP between January 2010 and december 2018 with at least one haemoculture positive. presence of at least a bacteremia as primary diagnosis, related diagnosis and associated diagnosis: A40 (streptococcus), A41 (staphylococcus, BGN, anaerobes, others), A32.7 (Listeria), A39.4 (meningocoele), A42.7 (Actinomyces), A02.1 (Salmonella), A54.8 (gonocoque), A48.0 (Clostridium). and/or in biological data presence of at least a haemoculture positive to Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Acinetobacter Baumannii, Enterococcus faecium, Enterococcus faecalis, Enterobacter cloacae, Pseudomonas aeruginosa, Streptococcus sp., Salmonella sp., Clostridium difficile. For control cohort: Patients cared in a hospital of APHP between 2010 and 2018 without infection. - Patients without infection of CIM-10 bacteraemia as primary diagnosis, related diagnosis and associated diagnosis, without haemoculture positive in microbiology. Exclusion Criteria: - Patients aged < 18 years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of bacteraemia |  | through study completion, an average of 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | Events of death will be recorded, the mortality rate will be calculated for 30 day and 90 day. | at 30 day and 90 day | 
| Rehospitalization | The rate of 12 months unplanned rehospitalization for infection by the same biological pathogenes was recorded. | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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bacteremia, resistant bacteria, antibiotic