دورية أكاديمية
Clinical outcomes of carbapenem-resistant gram-negative bacterial bloodstream infection in patients with end-stage renal disease in intensive care units: a multicenter retrospective observational study.
| العنوان: | Clinical outcomes of carbapenem-resistant gram-negative bacterial bloodstream infection in patients with end-stage renal disease in intensive care units: a multicenter retrospective observational study. |
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| المؤلفون: | Lin YC; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.; School of Medicine, China Medical University, Taichung, Taiwan., Yang KY; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.; Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Cancer and Immunology Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan., Peng CK; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan., Chan MC; Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan., Sheu CC; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Feng JY; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Wang SH; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.; Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan., Huang WH; Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan., Chen CM; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan., Chen DH; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. deanhc1022@gmail.com., Chen CL; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. loyin1217@gmail.com. |
| مؤلفون مشاركون: | TCARE (Taiwan Critical Care and Infection) Group |
| المصدر: | Infection [Infection] 2024 Jul 12. Date of Electronic Publication: 2024 Jul 12. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Heidelberg Country of Publication: Germany NLM ID: 0365307 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-0973 (Electronic) Linking ISSN: 03008126 NLM ISO Abbreviation: Infection Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2011- : Heidelberg : Springer Heidelberg Original Publication: München, Verlagsgesellschaft Otto Spatz. |
| مستخلص: | Background: Carbapenem-resistant gram-negative bacteria (CRGNB) present a considerable global threat due to their challenging treatment and increased mortality rates, with bloodstream infection (BSI) having the highest mortality rate. Patients with end-stage renal disease (ESRD) undergoing renal replacement therapy (RRT) face an increased risk of BSI. Limited data are available regarding the prognosis and treatment outcomes of CRGNB-BSI in patients with ESRD in intensive care units (ICUs). Methods: This multi-center retrospective observational study included a total of 149 ICU patients with ESRD and CRGNB-BSI in Taiwan from January 2015 to December 2019. Clinical and microbiological outcomes were assessed, and multivariable regression analysis was used to evaluate the independent risk factors for day-28 mortality and the impact of antimicrobial therapy regimen on treatment outcomes. Results: Among the 149 patients, a total of 127 patients (85.2%) acquired BSI in the ICU, with catheter-related infections (47.7%) and pneumonia (32.2%) being the most common etiologies. Acinetobacter baumannii (49.0%) and Klebsiella pneumoniae (31.5%) were the most frequently isolated pathogens. The day-28 mortality rate from BSI onset was 52.3%, and in-hospital mortality was 73.2%, with survivors experiencing prolonged hospital stays. A higher Sequential Organ Failure Assessment (SOFA) score (adjusted hazards ratio [aHR], 1.25; 95% confidence interval [CI] 1.17-1.35) and shock status (aHR, 2.12; 95% CI 1.14-3.94) independently predicted day-28 mortality. Colistin-based therapy reduced day-28 mortality in patients with shock, a SOFA score of ≥ 13, and Acinetobacter baumannii-related BSI. Conclusions: CRGNB-BSI led to high mortality in critically ill patients with ESRD. Day-28 mortality was independently predicted by a higher SOFA score and shock status. In patients with higher disease severity and Acinetobacter baumannii-related BSI, colistin-based therapy improved treatment outcomes. (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Bloodstream infection; Carbapenem-resistant; End-stage renal disease; Intensive care unit; Prognosis |
| تواريخ الأحداث: | Date Created: 20240712 Latest Revision: 20240712 |
| رمز التحديث: | 20240712 |
| DOI: | 10.1007/s15010-024-02343-5 |
| PMID: | 38995550 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1439-0973 |
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| DOI: | 10.1007/s15010-024-02343-5 |