Microbiologic characteristics and predictors of mortality in bloodstream infections in intensive care unit patients: A 1-year, large, prospective surveillance study in 5 Italian hospitals.

Autor: Delle Rose D; Clinical Infectious Diseases, Tor Vergata Hospital, Rome, Italy. Electronic address: diego.dellerose82@gmail.com., Sordillo P; Clinical Infectious Diseases, Tor Vergata Hospital, Rome, Italy., Gini S; Clinical Infectious Diseases, Tor Vergata Hospital, Rome, Italy., Cerva C; Clinical Infectious Diseases, Tor Vergata Hospital, Rome, Italy., Boros S; Istituto Superiore di Sanità, Rome, Italy., Rezza G; Istituto Superiore di Sanità, Rome, Italy., Meledandri M; S. Filippo Neri Hospital, Rome, Italy., Gallo MT; San Gallicano Dermatologic Institute, IRCCS, Istituti Fisioterapici Ospitalieri, Rome, Italy., Prignano G; San Gallicano Dermatologic Institute, IRCCS, Istituti Fisioterapici Ospitalieri, Rome, Italy., Caccese R; Intensive Care Unit, S. Giovanni Hospital, Rome, Italy., D'Ambrosio M; Intensive Care Unit, S. Giovanni Hospital, Rome, Italy., Citterio G; Intensive Care Unit, La Sapienza University, Rome, Italy., Rocco M; Intensive Care Unit, La Sapienza University, Rome, Italy., Leonardis F; Intensive Care Unit, Tor Vergata Hospital, Rome, Italy., Natoli S; Intensive Care Unit, Tor Vergata Hospital, Rome, Italy., Fontana C; Clinical Microbiology Laboratories, Tor Vergata Hospital, Rome, Italy., Favaro M; Clinical Microbiology Laboratories, Tor Vergata Hospital, Rome, Italy., Celeste MG; Clinical Pharmacy, Tor Vergata University, Rome, Italy., Franci T; S. Andrea Hospital, Rome, Italy., Testore GP; Clinical Infectious Diseases, Tor Vergata Hospital, Rome, Italy., Andreoni M; Clinical Infectious Diseases, Tor Vergata Hospital, Rome, Italy., Sarmati L; Clinical Infectious Diseases, Tor Vergata Hospital, Rome, Italy.
Jazyk: angličtina
Zdroj: American journal of infection control [Am J Infect Control] 2015 Nov; Vol. 43 (11), pp. 1178-83. Date of Electronic Publication: 2015 Aug 04.
DOI: 10.1016/j.ajic.2015.06.023
Abstrakt: Background: Bloodstream infections (BSIs) from multidrug-resistant (MDR) bacteria cause morbidity and mortality in intensive care unit (ICU) patients worldwide. This study investigated the incidence of BSIs in 5 adult general ICUs in Rome, Italy, and evaluated the mortality rate and risk factors associated with these infections.
Methods: Over a 12-month period, 1,318 patients were enrolled. Demographic characteristics, Simplified Acute Physiology Score II (SAPS II), comorbidities, and BSI isolate data were collected. After stratification for the outcome, statistical analysis was performed to assess the impact of patient risk factors on in-hospital mortality.
Results: There were 324 BSIs in 175 patients recorded, with an in-hospital mortality rate of 46%. Univariate analysis revealed that SAPS II, cardiac comorbidity, and Klebsiella pneumoniae BSI were significantly associated with a higher risk of death. Having a K pneumoniae BSI and cardiac illness at admission were both confirmed to be associated with death by multivariate analysis (P = .0162 and P = .0158, respectively). Most of the K pneumoniae isolates showed high resistance rates to carbapenems.
Conclusion: BSIs caused by K pneumoniae and cardiovascular comorbidity in ICU patients are associated with a higher risk of death. Thorough surveillance for MDR pathogens and stratification of the patients' risk on admission into the ICU are key to improving the outcomes of these infections.
(Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: