The clinical characteristics and risk factors of mortality in adult patients with carbapenem resistant Gram-negative bacteria blood infections
Author(s): Qu Jun-yan, Kang Mei, Lu Yang, Qin Jia-yuan, Lü Xiao-ju
Pages: 212-217
Year: 2017 Issue: 3
Journal: Chinese Journal of Antibiotics
Keyword: Carbapenem; Gram-negative bacteria; Resistance; Bloodstream infection; Clinical features; Risk factor;
Abstract: Objective To analyze the clinical characteristics and risk factors of mortality in adult patients with carbapenem resistant Gram-negative bacteria (CR-GNB) blood infections.Methods A retrospective study was carried out in 157 patients with confirmed diagnosis of CR-GNB blood infections from July 2014 to June 2016 in West China hospital,Sichuan University.The patients were divided into XDR group and non-XDR group according to whether the isolates were extensively drug-resistant bacteria.The clinical features and antibacterial drug therapies were reviewed.The risk factors of mortality associated with CR-GNB blood infections were examined with multivariate logistic regression analysis.Results There were 68 cases in XDR group and 89 cases in non-XDR group.The patients with CR-GNB blood infections mainly distributed in intensive care unit (ICU) and hematology department.The common underlying diseases were severe acute pancreatitis and tumor.All-cause mortality of CRGNB blood infections was 55.41％,and all-cause mortality in XDR group higher than that in non-XDR group (P＜0.05).The most common CR-GNB were Acinetobacter baumannii,Pseudomonas aeruginosa and Escherichia coli.Adjusting the antibacterial drug therapy according to the antimicrobial susceptibility results could improve the clinical outcome of CR-GNB blood infections,however,this difference was not statistically significant (P＞0.05).The multivariate logistic regression analysis showed that the risk factors of mortality associated with CR-GNB blood infections were patients over 65 (OR=3.059,95％ CI 1.117～8.380,P=0.030) and admission to ICU (OR=2.541,95％ CI 1.179～5.477,P=0.017) (P＜0.05).Conclusion The situation of CR-GNB infection is fairly severe.The elder patients in ICU were with poor prognosis.We should adopt effective measure to prevent the emerging of carbapenem resistant strains and explore the new treatment methods to improving outcomes for these patients.
Pages: 212-217
Year: 2017 Issue: 3
Journal: Chinese Journal of Antibiotics
Keyword: Carbapenem; Gram-negative bacteria; Resistance; Bloodstream infection; Clinical features; Risk factor;
Abstract: Objective To analyze the clinical characteristics and risk factors of mortality in adult patients with carbapenem resistant Gram-negative bacteria (CR-GNB) blood infections.Methods A retrospective study was carried out in 157 patients with confirmed diagnosis of CR-GNB blood infections from July 2014 to June 2016 in West China hospital,Sichuan University.The patients were divided into XDR group and non-XDR group according to whether the isolates were extensively drug-resistant bacteria.The clinical features and antibacterial drug therapies were reviewed.The risk factors of mortality associated with CR-GNB blood infections were examined with multivariate logistic regression analysis.Results There were 68 cases in XDR group and 89 cases in non-XDR group.The patients with CR-GNB blood infections mainly distributed in intensive care unit (ICU) and hematology department.The common underlying diseases were severe acute pancreatitis and tumor.All-cause mortality of CRGNB blood infections was 55.41％,and all-cause mortality in XDR group higher than that in non-XDR group (P＜0.05).The most common CR-GNB were Acinetobacter baumannii,Pseudomonas aeruginosa and Escherichia coli.Adjusting the antibacterial drug therapy according to the antimicrobial susceptibility results could improve the clinical outcome of CR-GNB blood infections,however,this difference was not statistically significant (P＞0.05).The multivariate logistic regression analysis showed that the risk factors of mortality associated with CR-GNB blood infections were patients over 65 (OR=3.059,95％ CI 1.117～8.380,P=0.030) and admission to ICU (OR=2.541,95％ CI 1.179～5.477,P=0.017) (P＜0.05).Conclusion The situation of CR-GNB infection is fairly severe.The elder patients in ICU were with poor prognosis.We should adopt effective measure to prevent the emerging of carbapenem resistant strains and explore the new treatment methods to improving outcomes for these patients.
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