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Extending the classification of healthcare-associated bloodstream infection to other main foci: respiratory, urinary and intra-abdominal


Healthcare-associated infection (HCAI) is a growing phenomena associated with the increase of the outpatient clinical care. Friedman in 2002 proposed a new classification for healthcare-associated bloodstream infections, suggesting that they are different from nosocomial and community-acquired infections [1]. The authors extend this classification to other main focus of infection: respiratory, urinary and intra-abdominal.


A prospective cohort study (1 year), in five wards of a university hospital, including all consecutive adult patients that met the CDC definition of infection. Only the first episode of infection was characterized. They were classified in community-acquired (CAI), HCAI (using Friedman's classification [1]) and hospital-acquired (HAI), and data on the host and the infectious episode were collected.


See Figure 1. We included 1,035 patients: 493 (48%) with CAI, 225 (22%) with HCAI and 317 (31%) with HAI.

Figure 1
figure 1

Microbiological profile according to the focus of infection.


Differences were observed according to the type and focus of infection. These results reinforce the need for this classification and probably the need for specific antibiotic therapy guidelines for this group of patients.


  1. Friedman ND, et al.: Ann Intern Med. 2002, 137: 791-797.

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Cardoso, C., Ribeiro, O., Aragão, I. et al. Extending the classification of healthcare-associated bloodstream infection to other main foci: respiratory, urinary and intra-abdominal. Crit Care 15 (Suppl 1), P214 (2011).

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