دورية أكاديمية
Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study.
| العنوان: | Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study. |
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| المؤلفون: | Lima EM; Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (IOC/FIOCRUZ), Rio de Janeiro, RJ, Brazil.; Hospital Federal dos Servidores do Estado (HFSE), Ministry of Health, Rio de Janeiro, RJ, Brazil., Cid PA; Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (IOC/FIOCRUZ), Rio de Janeiro, RJ, Brazil., Beck DS; Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (IOC/FIOCRUZ), Rio de Janeiro, RJ, Brazil., Pinheiro LHZ; Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (IOC/FIOCRUZ), Rio de Janeiro, RJ, Brazil., Tonhá JPS; Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (IOC/FIOCRUZ), Rio de Janeiro, RJ, Brazil., Alves MZO; Hospital Federal dos Servidores do Estado (HFSE), Ministry of Health, Rio de Janeiro, RJ, Brazil., Lourenço ND; Hospital Federal dos Servidores do Estado (HFSE), Ministry of Health, Rio de Janeiro, RJ, Brazil., Santos RQ; Hospital Federal dos Servidores do Estado (HFSE), Ministry of Health, Rio de Janeiro, RJ, Brazil., Asensi MD; Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (IOC/FIOCRUZ), Rio de Janeiro, RJ, Brazil., Marques JA; Hospital Federal dos Servidores do Estado (HFSE), Ministry of Health, Rio de Janeiro, RJ, Brazil., Bandeira CS; Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (IOC/FIOCRUZ), Rio de Janeiro, RJ, Brazil., Rodrigues CAS; Hospital Federal dos Servidores do Estado (HFSE), Ministry of Health, Rio de Janeiro, RJ, Brazil., Gomes Junior SCS; Instituto Fernandes Figueira, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil., Gomes MZR; Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (IOC/FIOCRUZ), Rio de Janeiro, RJ, Brazil. marisargomes@ioc.fiocruz.br.; Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (IOC/FIOCRUZ), Rio de Janeiro, RJ, Brazil. marisargomes@ioc.fiocruz.br.; Hospital Federal dos Servidores do Estado (HFSE), Ministry of Health, Rio de Janeiro, RJ, Brazil. marisargomes@ioc.fiocruz.br. |
| مؤلفون مشاركون: | Nucleus of Hospital Research study collaborators |
| المصدر: | Antimicrobial resistance and infection control [Antimicrob Resist Infect Control] 2020 Aug 14; Vol. 9 (1), pp. 132. Date of Electronic Publication: 2020 Aug 14. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101585411 Publication Model: Electronic Cited Medium: Internet ISSN: 2047-2994 (Electronic) Linking ISSN: 20472994 NLM ISO Abbreviation: Antimicrob Resist Infect Control Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central |
| مواضيع طبية MeSH: | Anti-Bacterial Agents/*therapeutic use , Carbapenems/*therapeutic use , Gram-Negative Bacteria/*drug effects , Gram-Negative Bacterial Infections/*blood , Intensive Care Units/*statistics & numerical data , Sepsis/*microbiology, Adult ; Aged ; Aged, 80 and over ; Brazil ; Case-Control Studies ; Critical Illness ; Cross Infection/drug therapy ; Cross Infection/microbiology ; Female ; Gram-Negative Bacteria/pathogenicity ; Gram-Negative Bacterial Infections/drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Recurrence ; Risk Factors ; Sepsis/drug therapy ; Tertiary Care Centers/statistics & numerical data ; Young Adult |
| مستخلص: | Background: Studies have investigated risk factors for infections by specific species of carbapenem-resistant Gram-negative bacilli (CR-GNB), but few considered the group of GNB species and most of them were performed in the setting of bacteremia or hospital infection. This study was implemented to identify risk factors for sepsis by CR- and carbapenem-susceptible (CS) GNB in intensive care unit (ICU) patients to improve management strategies for CR-GNB sepsis. Methods: We developed a case-case-control study from a prospective cohort of patients with systemic inflammatory response syndrome (SIRS), sepsis-2 or sepsis-3 criteria in which blood and other sample cultures were collected and antimicrobial therapy was instituted, in an adult clinical-surgical ICU, at tertiary public hospital in Rio de Janeiro, from August 2015 through March 2017. Results: Among the total of 629 ICU admissions followed by 7797 patient-days, after applying inclusion and exclusion criteria we identified 184 patients who developed recurrent or single hospital-acquired sepsis. More than 90% of all evaluable cases of sepsis and 87% of control group fulfilled the modified sepsis-3 definition. Non-fermenting bacilli and ventilator-associated pneumonia predominated as etiology and source of CR-GNB sepsis. While Enterobacteriaceae and intra-abdominal surgical site plus urinary-tract infections prevailed in CS-GNB than CR-GNB sepsis. Carbapenemase production was estimated in 76% of CR-GNB isolates. Multivariate logistic regression analysis revealed previous infection (mostly hospital-acquired bacterial infection or sepsis) (OR = 4.28; 95% CI 1.77-10.35), mechanical ventilation (OR = 4.21; 95% CI 1.17-15.18), carbapenem use (OR = 3.42; 95% CI 1.37-8.52) and length of hospital stay (OR = 1.03; 95% CI 1.01-1.05) as independent risk factors for sepsis by CR-GNB. While ICU readmission (OR = 6.92; 95% CI 1.72-27.78) and nosocomial diarrhea (OR = 5.32; 95% CI 1.07-26.45) were factors associated with CS-GNB sepsis. Conclusions: The investigation of recurrent and not only bacteremic episodes of sepsis was the differential of this study. The results are in agreement with the basic information in the literature. This may help improve management strategies and future studies on sepsis by CR-GNB. |
| References: | Braz J Infect Dis. 2009 Oct;13(5):341-7. (PMID: 20428632) Crit Care Clin. 2006 Apr;22(2):291-311, vii. (PMID: 16678001) PLoS One. 2015 Apr 24;10(4):e0123337. (PMID: 25909482) Crit Care Res Pract. 2014;2014:480463. (PMID: 25525515) Clin Microbiol Infect. 2012 Mar;18(3):268-81. (PMID: 21793988) Intensive Care Med. 2013 Jul;39(7):1253-61. (PMID: 23604133) Clin Microbiol Infect. 2015 Jan;21(1):30-4. (PMID: 25636924) Int J Infect Dis. 2010 Sep;14(9):e764-9. (PMID: 20646946) J Med Microbiol. 2014 Dec;63(Pt 12):1679-1687. (PMID: 25261066) Clin Microbiol Infect. 2017 Feb;23(2):104-109. (PMID: 27856268) Eur J Clin Microbiol Infect Dis. 2016 Oct;35(10):1679-89. (PMID: 27401905) Eur J Anaesthesiol. 2010 May;27(5):486-90. (PMID: 20386386) J Microbiol Immunol Infect. 2018 Oct;51(5):621-628. (PMID: 28732563) Crit Care. 2011;15(2):R100. (PMID: 21418635) Antimicrob Agents Chemother. 2015 Oct 19;60(1):252-7. (PMID: 26482315) Int J Antimicrob Agents. 2009 Jul;34(1):25-8. (PMID: 19216059) Virulence. 2016 Apr 2;7(3):267-79. (PMID: 26760527) Am J Infect Control. 2014 Feb;42(2):206-8. (PMID: 24485378) Infection. 2010 Jun;38(3):173-80. (PMID: 20224962) JAMA. 2016 Feb 23;315(8):801-10. (PMID: 26903338) Emerg Infect Dis. 2011 Oct;17(10):1791-8. (PMID: 22000347) PLoS Med. 2007 Oct 16;4(10):e296. (PMID: 17941714) Clin Microbiol Rev. 2007 Jul;20(3):440-58, table of contents. (PMID: 17630334) Crit Care Med. 2003 Apr;31(4):1250-6. (PMID: 12682500) Colomb Med (Cali). 2014 Jun 30;45(2):54-60. (PMID: 25100889) J Glob Antimicrob Resist. 2013 Mar;1(1):7-16. (PMID: 27873609) Braz J Infect Dis. 2012 May-Jun;16(3):219-25. (PMID: 22729187) PLoS One. 2014 Nov 06;9(11):e112208. (PMID: 25375244) Infect Control Hosp Epidemiol. 2005 Apr;26(4):346-51. (PMID: 15865269) Med Sci Monit. 2015 Jan 17;21:219-24. (PMID: 25595166) Clin Infect Dis. 2001 Apr 1;32(7):1055-61. (PMID: 11264034) J Infect Chemother. 2014 May;20(5):293-7. (PMID: 24703709) Eur J Clin Microbiol Infect Dis. 2018 Jan;37(1):43-50. (PMID: 28879405) BMC Infect Dis. 2014 Nov 28;14:489. (PMID: 25431091) Diagn Microbiol Infect Dis. 2011 Jun;70(2):274-7. (PMID: 21397425) Crit Care Med. 2013 Oct;41(10):2373-8. (PMID: 23921277) Clin Infect Dis. 2005 Sep 15;41(6):848-54. (PMID: 16107985) Intensive Care Med. 2012 Dec;38(12):1930-45. (PMID: 23011531) J Infect. 2016 Oct;73(4):336-45. (PMID: 27404978) JAMA. 2016 Feb 23;315(8):762-74. (PMID: 26903335) Expert Rev Anti Infect Ther. 2010 Jan;8(1):71-93. (PMID: 20014903) |
| فهرسة مساهمة: | Investigator: GRAA Magalhães; PP Silva; SMSAS Reis Di Chiara; AAS Machado; TM Tozo; LLPA Rosas; PCM Barros; WV de Freitas; APDC Assef Keywords: Antimicrobial resistance; Gram-negative bacilli; Hospital infection; Polymerase chain reaction; Risk factors; Sepsis |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) 0 (Carbapenems) |
| تواريخ الأحداث: | Date Created: 20200816 Date Completed: 20210712 Latest Revision: 20210712 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC7426895 |
| DOI: | 10.1186/s13756-020-00791-w |
| PMID: | 32795380 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 2047-2994 |
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| DOI: | 10.1186/s13756-020-00791-w |