scholarly journals Evaluation of Sepsis and Extensively Drug Resistant Infections in Deceased Critically Ill Patients

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Fatma İrem Yeşiler ◽  
Çağla Yazar ◽  
İrem Ulutaş Ordu ◽  
Helin Şahintürk ◽  
Tuğba Yanık Yalçın ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Drug Resistant ◽  
Extensively Drug Resistant

scholarly journals Colonization with Extensively Drug-Resistant Acinetobacter Baumannii and Prognosis in Critically Ill Patients: An Observational Cohort Study

2021 ◽  
Author(s):  
Yue Zheng ◽  
Nana Xu ◽  
Jiaojiao Pang ◽  
Hui Han ◽  
Hongna Yang ◽  
...  
Keyword(s):  
Regression Model ◽  
Acinetobacter Baumannii ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Drug Resistant ◽  
Short Term ◽  
Term Survival ◽  
Extensively Drug Resistant ◽  
Kaplan Meier

Abstract Background: Acinetobacter baumannii is one of the most often isolated opportunistic pathogens in intensive care units (ICUs). Extensively drug-resistant A. baumannii (XDR-AB) strains lack susceptibility to almost all antibiotics and pose a heavy burden on healthcare institutions. In this study, we evaluated the impact of XDR-AB colonization on both the short-term and long-term survival of critically ill patients.Methods: We prospectively enrolled patients from two adult ICUs in Qilu Hospital of Shandong University from April 2018 through December 2018. Using nasopharyngeal and perirectal swabs, we evaluated the presence of XDR-AB colonization. Participants were followed up for six months. Primary endpoints were 28-day and six-month mortality after ICU admission. For survival analysis, we used the Kaplan-Meier curve. We identified risk factors associated with 28-day and six-month mortality using the logistic regression model and Cox proportional-hazards survival regression model, respectively. Results: Out of 431 patients, 77 were colonized with XDR-AB. Based on the Kaplan-Meier curve results, the survival before 28 days did not differ by colonization status; however, a significant lower survival rate was obtained at six months in colonized patients. Univariate and multivariate results confirmed that XDR-AB colonization was not associated with 28-day mortality, but was an independent risk factor of lower survival days at six months, resulting in a 1.97 times higher risk of death at six months.Conclusions: XDR-AB colonization has no effect on short-term mortality but is associated with lower long-term survival in critically ill patients.

scholarly journals Colonization with Extensively Drug-Resistant Acinetobacter baumannii and Prognosis in Critically Ill Patients: An Observational Cohort Study

2021 ◽  
Author(s):  
Yue Zheng ◽  
Nana Xu ◽  
Jiaojiao Pang ◽  
Hui Han ◽  
Hongna Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Drug Resistant ◽  
Overall Survival Rate ◽  
Short Term ◽  
Extensively Drug Resistant ◽  
Kaplan Meier

Abstract BackgroundAcinetobacter baumannii is one of the most frequently isolated opportunistic pathogens in intensive care units (ICUs). Extensively drug-resistant A. baumannii (XDR-AB) strains lack susceptibility to almost all antibiotics and pose a heavy burden on healthcare institutions. In this study, we evaluated the impact of XDR-AB colonization on both the short-term and long-term survival of critically ill patients.MethodsWe prospectively enrolled patients from two adult ICUs in Qilu Hospital of Shandong University from March 2018 through December 2018. Using nasopharyngeal and perirectal swabs, we evaluated the presence of XDR-AB colonization. Participants were followed up for 6 months. The primary endpoints were 28-day and 6-month mortality after ICU admission. The overall survival rate was estimated by the Kaplan-Meier method. We identified risk factors associated with 28-day and 6-month mortality using the logistic regression model and a time-dependent Cox regression model, respectively. ResultsOut of 431 patients, 77 were colonized with XDR-AB. Based on the Kaplan-Meier curve results, the overall survival before 28 days did not differ by colonization status; however, a significantly lower overall survival rate was obtained at 6 months in colonized patients. Univariate and multivariate analysis results confirmed that XDR-AB colonization was not associated with 28-day mortality, but was an independent risk factor of lower overall survival at 6 months (HR = 1.749, 95% CI = 1.174–2.608).ConclusionsXDR-AB colonization has no effect on short-term overall survival, but is associated with lower long-term overall survival in critically ill patients.

scholarly journals Colonization With Extensively Drug-Resistant Acinetobacter baumannii and Prognosis in Critically Ill Patients: An Observational Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Yue Zheng ◽  
Nana Xu ◽  
Jiaojiao Pang ◽  
Hui Han ◽  
Hongna Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Drug Resistant ◽  
Overall Survival Rate ◽  
Short Term ◽  
Extensively Drug Resistant ◽  
Kaplan Meier

Background:Acinetobacter baumannii is one of the most frequently isolated opportunistic pathogens in intensive care units (ICUs). Extensively drug-resistant A. baumannii (XDR-AB) strains lack susceptibility to almost all antibiotics and pose a heavy burden on healthcare institutions. In this study, we evaluated the impact of XDR-AB colonization on both the short-term and long-term survival of critically ill patients.Methods: We prospectively enrolled patients from two adult ICUs in Qilu Hospital of Shandong University from March 2018 through December 2018. Using nasopharyngeal and perirectal swabs, we evaluated the presence of XDR-AB colonization. Participants were followed up for 6 months. The primary endpoints were 28-day and 6-month mortality after ICU admission. The overall survival rate was estimated by the Kaplan-Meier method. We identified risk factors associated with 28-day and 6-month mortality using the logistic regression model and a time-dependent Cox regression model, respectively.Results: Out of 431 patients, 77 were colonized with XDR-AB. Based on the Kaplan-Meier curve results, the overall survival before 28 days did not differ by colonization status; however, a significantly lower overall survival rate was obtained at 6 months in colonized patients. Univariate and multivariate analysis results confirmed that XDR-AB colonization was not associated with 28-day mortality, but was an independent risk factor of lower overall survival at 6 months (HR = 1.749, 95% CI = 1.174–2.608).Conclusions: XDR-AB colonization has no effect on short-term overall survival, but is associated with lower long-term overall survival in critically ill patients.

scholarly journals Multi-Drug Resistant Gram-Negative Infections Among Critically Ill Patients: Analysis of Baseline Characteristics and Factors Associated with Mortality

2020 ◽  
Author(s):  
Fadi Aljamaan ◽  
Esraa Altawil ◽  
Mohamad-Hani Temsah ◽  
Ahmad Almeman
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Drug Resistant ◽  
Gram Negative ◽  
Factors Associated ◽  
Icu Length Of Stay ◽  
Acinetobacter Spp ◽  
Apache Iv

Abstract BackgroundBacterial infections are a frequent cause of hospitalization and a leading cause of death, particularly with the emergence of antibiotics resistance. The emergence of Carbapenem resistance among gram-negative bacteria (GNB) is one of the evolving alerts as its use is considered the last resort of treatment [1]. Therefore, this urged studying the risk factors for the development of multi-drug resistant [2] GNB, identify the clinical outcomes and factors associated with mortality, especially among critically ill patients who are expected to have the worst outcomes.Materials/methodsThis is a retrospective observational study of critically ill patients who had an infection with Carbapenem-resistant Enterobacteriaceae (CRE), or MDR Pseudomonas aeruginosa, or MDR Acinetobacter spp. between May 2016- Nov 2018. Baseline demographics, co-morbidities, and clinical outcomes were collected and were evaluated for association with 28 days mortality. ResultsA total of 255 patients with MDR Gram-negative cultures were screened, 77 patients met the inclusion criteria. Pseudomonas aeruginosa was the most common index organism (53% of patients), followed by Acinetobacter spp. and CRE, respectively. The mortality rate at 28 days was (59.7%). Non-survivors were significantly older (mean age 64 vs. 44 years, P= 0.0001), had significantly worse disease severity scores on ICU admission, higher incidence of chronic kidney disease (CKD) (43% vs. 16%, P= 0.010), required more continuous renal replacement therapy (CRRT) (54% vs. 13% P= 0.0001), had longer hospital length of stay prior to infection (median 34 vs. 13 days, P= 0.018), and required longer inotropic and vasopressors support (median 19 vs. 8 days, P = 0.0001). In multivariate logistic regression the following factors were significantly associated with mortality; requirement of inotropic support [OR 10.01 (95% CI 1.55-64.77); P= 0.015], age [OR 1.05 (95% CI 1.0-1.1); P=0.01], APACHE IV score on ICU admission [OR 1.03 (95% CI 1.0- 1.06); P= 0.04], and ICU length of stay [OR 1.03 (95% CI 1.0- 1.06); P= 0.035].ConclusionMDR Gram-negative infection is associated with significant in-hospital mortality among critically ill patients. Old age, high APACHE IV score, higher ICU length of stay, and higher hemodynamic support are associated with higher mortality.Trial registrationretrospectively registered.

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