Bloodstream infections in hospitalized adults with dengue fever: Clinical characteristics and recommended empirical therapy
| Autor: | Chia Wen Li, Ming Chi Li, Yuan Pin Hung, Pei Fang Tsai, Hung-Jen Tang, Nan Yao Lee, Ching Chuan Liu, Po Lin Chen, Ling Shan Syue, Wen Chien Ko |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Male lcsh:QR1-502 Bacteremia Levofloxacin lcsh:Microbiology Dengue fever Dengue 0302 clinical medicine Risk Factors Immunology and Allergy 030212 general & internal medicine Cefepime Escherichia coli Infections Aged 80 and over Coinfection Mortality rate Enterobacteriaceae Infections General Medicine Middle Aged Staphylococcal Infections Hospitals Anti-Bacterial Agents Infectious Diseases Piperacillin Tazobactam Drug Combination Female medicine.drug Microbiology (medical) medicine.medical_specialty 030106 microbiology Taiwan Microbial Sensitivity Tests Tazobactam 03 medical and health sciences Enterobacteriaceae Internal medicine medicine Escherichia coli Humans Risk factor Mortality Aged Retrospective Studies General Immunology and Microbiology business.industry Candidemia Streptococcus medicine.disease business Piperacillin |
| Zdroj: | Journal of Microbiology, Immunology and Infection, Vol 52, Iss 2, Pp 225-232 (2019) |
| ISSN: | 1684-1182 |
| Popis: | Background: Dengue is an important mosquito-borne tropical viral disease and dual infection, though rare, has been regarded as a risk factor for severe disease and mortality. However, few studies focused on bloodstream infections (BSIs) and empirical antibiotic therapy rarely addressed. Methods: Dengue patients with concurrent or subsequent BSIs between July 1 and December 31, 2015 were included. Clinical information, laboratory data, and drug susceptibility data were collected. Results: Totally 80 patients, with an in-hospital mortality rate of 32.5%, were included and categorized into three groups. 32 patients in Group I (BSI onset within 48 h after admission), 32 in Group II (between 48 h and one week), and 16 in Group III (more than one week). Patients in Group I were older (mean age: 75.6 vs. 72.6 or 69.6 years; P = 0.01) and had a higher Charlson comorbidity index (3.1 vs. 1.8 or 1.9; P = 0.02) than those in Group II or III. Streptococcus species (28.9%, 11/38) and Escherichia coli (23.7%, 9/38) were major pathogens in Group I. Enterobacteriaceae (38.2%, 13/34) isolates predominated in Group II. Fatal patients more often received inappropriate empirical antibiotic than the survivors (61.5% vs. 35.2%; P = 0.03). According to susceptibility data, pathogens in Group I and II shared similar susceptibility profiles, and levofloxacin, cefepime, or piperacillin/tazobactam, can be empirically prescribed for those hospitalized within one week. Conclusions: BSI pathogens vary among dengue patients. For adults with dengue and suspected BSI hospitalized within one week, empirical antimicrobial agents are recommended. Keywords: Severe dengue, Sepsis, Bacteremia, Candidemia, Empirical therapy, Concurrent infection, Fatality |
| Databáze: | OpenAIRE |
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