scholarly journals Risk Factors for and Clinical Outcomes of Multidrug-Resistant Gram-Negative Bacterial Bloodstream Infections: Initial Results From a 12-Year Prospective Cohort Study

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Joshua T. Thaden ◽  
Yanhong Li ◽  
Felicia Ruffin ◽  
Shelby Reed ◽  
Vance Fowler
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Gram Negative ◽  
Initial Results

scholarly journals Risk Factors for Carbapenem Resistance in Gram Negative Nosocomial Pneumonia: A Single Centre Prospective Cohort Study

2021 ◽  
Author(s):  
Swayambhu Banerjee ◽  
Renoy Henry ◽  
Sandeep Surendran ◽  
Abhiram Pillai ◽  
Rema Pai
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Nosocomial Pneumonia ◽  
Prospective Cohort ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Tertiary Care Centre ◽  
Gram Negative ◽  
Stewardship Program

Introduction: Gram Negative Bacilli (GNB) account for about 70% of Hospital Acquired Pneumonia (HAP), Ventilator Acquired Pneumonia (VAP) and Healthcare Associated Pneumonia (HCAP). Increasing use of carbapenems lead to infections caused by GNBs with therapeutically challenging Extended-Spectrum Beta-Lactamases (ESBLs). Aim: To assess the risk factors and clinical outcomes associated with HAP, VAP and HCAP caused by Carbapenem Resistant (CR) GNB at a Tertiary Care Centre. Materials and Methods: The present study was a prospective cohort study which was conducted from February 2015 to September 2016 that included 66 patients with Broncho Alveolar Lavage (BAL) cultures for GNB. Clinical, demographic and microbiological data (including antibiotic sensitivity) along with overall mortality, occurrence of sepsis and length of stay were collected for each patient. Data were analysed using OpenStat 30.0 along with relevant descriptive statistics. Comparison of outcomes between CR and Carbapenem Sensitive (CS) group were studied along with the concordance between initial antibiotics and BAL culture sensitivity. Results: Overall prevalence of CR in the cohort was 54.54%. The most common organism to be ESBL positive was Klebsiella pneumoniae (45.45%). Exposure to previous antibiotics was a risk factor for CR (p=0.017). Mortality was higher (50%) in CR group than in CS group (23.3%; p=0.026). There were 45.8% of the cases having lack of concordance of initial antibiotics that died in comparison to 16.7% who had an appropriate initial antibiotic therapy (p=0.030). Conclusion: There is a high prevalence of CR in nosocomial pneumonia. Judicious use of antibiotics is the need of the hour and can be implemented by an Antibiotic Stewardship program.

scholarly journals Effect of cefepime dose on mortality of patients with Gram-negative bacterial bloodstream infections: a prospective cohort study

2014 ◽  
Vol 69 (6) ◽  
pp. 1681-1687 ◽  
Author(s):  
M. D. Alves ◽  
V. B. Ribeiro ◽  
J. P. Tessari ◽  
F. Mattiello ◽  
G. De Bacco ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Bloodstream Infections ◽  
Gram Negative

scholarly journals Risk factors for functional decline among survivors of Gram-negative bloodstream infection: A prospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259707
Author(s):  
Adi Turjeman ◽  
Fidi Koppel ◽  
Erica Franceschini ◽  
Dafna Yahav ◽  
Giovanni Dolci ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Functional Dependence ◽  
Controlled Trial ◽  
Functional Decline ◽  
Multivariable Analysis ◽  
Gram Negative ◽  
Gram Negative Bacteremia

Objective To identify risk factors for functional decline after hospitalization for Gram-negative bacteremia. Patients and methods A prospective cohort study based on a randomized controlled trial conducted between January 1, 2013 and August 31, 2017 in Israel and Italy. Hospitalized patients with Gram-negative bacteremia who survived until day 90 and were not bedridden at baseline were included. The primary end point was functional decline at 90 days. Results Five hundred and nine patients were included. The median age of the cohort was 71 years (interquartile range [IQR], 60–80 years), 46.4% (236/509) were male and 352 of 509 (69%) patients were independent at baseline. Functional decline at 90 days occurred in 24.4% of patients (124/509). In multivariable analysis; older age (odds ratio [OR], 1.03; for an one-year increment, 95% confidence interval [CI] 1.01–1.05), functional dependence in instrumental activities of daily living at baseline (OR, 4.64; 95% CI 2.5–8.6), low Norton score (OR, 0.87; 95% CI 0.79–0.96) and underlying comorbidities: cancer (OR, 2.01; 95% CI 1.14–3.55) and chronic pulmonary disease (OR, 2.23 95% CI 1.12–4.42) and longer length of hospital stay (OR 1.09; for one-day increment, 95% CI 1.04–1.15) were associated with functional decline. Appropriate empirical antibiotic treatment was associated with lower rates of functional decline within 90 days (OR, 0.4; 95% CI 0.21–0.78). Conclusions Patients surviving bloodstream infections have poor long term trajectories after clinical recovery and hospital discharge. This has vast implications for patients, their family members and health policy makers.

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