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. |
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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 |
تدمد: | 2047-2994 |
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DOI: | 10.1186/s13756-020-00791-w |