Prognostic Risk Factors of Carbapenem-Resistant Gram-Negative Bacteria Bloodstream Infection in Immunosuppressed Patients: A 7-Year Retrospective Cohort Study
Purpose: Carbapenem-resistant Gram-negative bacteria bloodstream infection (CRGNB-BSI) has gradually become a major threat worldwide due to its treatment difficulty and high mortality. This study aimed to determine the risk factors for CRGNB- BSI in immunosuppressed patients. Patients and Methods: A...
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| Veröffentlicht in: | Infection and Drug Resistance 2022, Vol.15, p.6451 |
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| container_title | Infection and Drug Resistance |
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| creator | Gao, Yulian Lin, Hongxia Xu, Yumin Yao, Yijin Shi, Dake Li, Junjie Zhu, Haixing Summah, Hanssa Dwarka Ni, Lei Feng, Yun |
| description | Purpose: Carbapenem-resistant Gram-negative bacteria bloodstream infection (CRGNB-BSI) has gradually become a major threat worldwide due to its treatment difficulty and high mortality. This study aimed to determine the risk factors for CRGNB- BSI in immunosuppressed patients. Patients and Methods: A total of 427 immunosuppressed patients with CRGNB-BSI were retrospectively investigated from 2015 to 2021. Both univariate and multivariate logistic regression analyses were applied to evaluate independent risk factors for CRGNB-BSI. Results: The most common etiology was Klebsiella Pneumoniae (50.59%; 216/427), while the Acinetobacillus baumannii infection was associated with the highest mortality (58.25%) among all etiologies. The 60-day mortality of immunosuppressed patients with CRGNB-BSI was 52.48% (224/427). Procalcitonin (PCT) > 0.5 [micro]g/L (OR = 2.32, 95% CI: 1.28-4.19, P = 0.005) and age > 55 years (OR = 2.06, 95% CI: 1.17-3.64, P = 0.012) were found to be predictors of 60-day mortality of CRGNB-BSI, and tigecycline regimen (OR = 3.20, 95% CI: 1.81-5.67, P < 0.001) was associated with higher mortality. Multivariate analysis also revealed that patients who developed acute kidney injury (AKI) (OR = 2.19, 95% CI: 1.11-4.30, P = 0.023), gastrointestinal bleeding (OR = 3.18, 95% CI: 1.109.16, P = 0.032), multiple organ dysfunction syndrome (MODS) (OR = 12.11, 95% CI: 2.61-56.19, P = 0.001), and septic shock (OR = 3.24, 95% CI: 1.77-5.94, P < 0.001) showed worse outcomes. The risk factors were also significantly associated with mortality in the different subgroups. Conclusion: This study demonstrated that PCT > 0.5 [micro]g/L, age > 55 years, and the tigecycline regimen were significantly associated with higher 60-day mortality among immunosuppressed patients with CRGNB- BSI. Patients developing MODS, septic shock, or AKI had worse clinical outcomes. Keywords: bloodstream infection, carbapenem-resistant, immunosuppressed patients, subgroups, prognosis |
| doi_str_mv | 10.2147/IDR.S386342 |
| format | Report |
| fullrecord | <record><control><sourceid>gale</sourceid><recordid>TN_cdi_gale_infotracacademiconefile_A731040066</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A731040066</galeid><sourcerecordid>A731040066</sourcerecordid><originalsourceid>FETCH-gale_infotracacademiconefile_A7310400663</originalsourceid><addsrcrecordid>eNqVjE1OwzAQRi0EEhV0xQXmAgn5U9yyawOl2aAqZcMKmWQSDLEn8jhIXIazYiQWbJlZzKdP854QV2kSZ2khr-vbJj7mqzIvshOxSFO5isq1zE__5HOxZH5LwuTrspDZQnwdHA2W2OsWGs3vsFOtJ8dAPVTKvagJLZqoQdbslfVw75SJHnBQXn8gbMM3Oq1gOxJ17B0qA7XtsfWaLGgLtTFz8M_T5JAZOzgEEq3nG9iAjJ5QOWjQO-LpBwrOil7JeTj6ufu8FGe9GhmXv_dCxLu7x2ofDWrEZ2178k61YTs0uiWLvQ79RuZpUiRJWeb_Br4Be6RqdA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>report</recordtype></control><display><type>report</type><title>Prognostic Risk Factors of Carbapenem-Resistant Gram-Negative Bacteria Bloodstream Infection in Immunosuppressed Patients: A 7-Year Retrospective Cohort Study</title><source>Taylor & Francis Open Access</source><source>DOVE Medical Press Journals</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Gao, Yulian ; Lin, Hongxia ; Xu, Yumin ; Yao, Yijin ; Shi, Dake ; Li, Junjie ; Zhu, Haixing ; Summah, Hanssa Dwarka ; Ni, Lei ; Feng, Yun</creator><creatorcontrib>Gao, Yulian ; Lin, Hongxia ; Xu, Yumin ; Yao, Yijin ; Shi, Dake ; Li, Junjie ; Zhu, Haixing ; Summah, Hanssa Dwarka ; Ni, Lei ; Feng, Yun</creatorcontrib><description>Purpose: Carbapenem-resistant Gram-negative bacteria bloodstream infection (CRGNB-BSI) has gradually become a major threat worldwide due to its treatment difficulty and high mortality. This study aimed to determine the risk factors for CRGNB- BSI in immunosuppressed patients. Patients and Methods: A total of 427 immunosuppressed patients with CRGNB-BSI were retrospectively investigated from 2015 to 2021. Both univariate and multivariate logistic regression analyses were applied to evaluate independent risk factors for CRGNB-BSI. Results: The most common etiology was Klebsiella Pneumoniae (50.59%; 216/427), while the Acinetobacillus baumannii infection was associated with the highest mortality (58.25%) among all etiologies. The 60-day mortality of immunosuppressed patients with CRGNB-BSI was 52.48% (224/427). Procalcitonin (PCT) > 0.5 [micro]g/L (OR = 2.32, 95% CI: 1.28-4.19, P = 0.005) and age > 55 years (OR = 2.06, 95% CI: 1.17-3.64, P = 0.012) were found to be predictors of 60-day mortality of CRGNB-BSI, and tigecycline regimen (OR = 3.20, 95% CI: 1.81-5.67, P < 0.001) was associated with higher mortality. Multivariate analysis also revealed that patients who developed acute kidney injury (AKI) (OR = 2.19, 95% CI: 1.11-4.30, P = 0.023), gastrointestinal bleeding (OR = 3.18, 95% CI: 1.109.16, P = 0.032), multiple organ dysfunction syndrome (MODS) (OR = 12.11, 95% CI: 2.61-56.19, P = 0.001), and septic shock (OR = 3.24, 95% CI: 1.77-5.94, P < 0.001) showed worse outcomes. The risk factors were also significantly associated with mortality in the different subgroups. Conclusion: This study demonstrated that PCT > 0.5 [micro]g/L, age > 55 years, and the tigecycline regimen were significantly associated with higher 60-day mortality among immunosuppressed patients with CRGNB- BSI. Patients developing MODS, septic shock, or AKI had worse clinical outcomes. Keywords: bloodstream infection, carbapenem-resistant, immunosuppressed patients, subgroups, prognosis</description><identifier>ISSN: 1178-6973</identifier><identifier>EISSN: 1178-6973</identifier><identifier>DOI: 10.2147/IDR.S386342</identifier><language>eng</language><publisher>Dove Medical Press Limited</publisher><subject>China ; Development and progression ; Gram-negative bacteria ; Health aspects ; Imipenem ; Infection ; Medical research ; Medicine, Experimental ; Mortality ; Risk factors ; Septic shock</subject><ispartof>Infection and Drug Resistance, 2022, Vol.15, p.6451</ispartof><rights>COPYRIGHT 2022 Dove Medical Press Limited</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>776,780,860,4476,27902</link.rule.ids></links><search><creatorcontrib>Gao, Yulian</creatorcontrib><creatorcontrib>Lin, Hongxia</creatorcontrib><creatorcontrib>Xu, Yumin</creatorcontrib><creatorcontrib>Yao, Yijin</creatorcontrib><creatorcontrib>Shi, Dake</creatorcontrib><creatorcontrib>Li, Junjie</creatorcontrib><creatorcontrib>Zhu, Haixing</creatorcontrib><creatorcontrib>Summah, Hanssa Dwarka</creatorcontrib><creatorcontrib>Ni, Lei</creatorcontrib><creatorcontrib>Feng, Yun</creatorcontrib><title>Prognostic Risk Factors of Carbapenem-Resistant Gram-Negative Bacteria Bloodstream Infection in Immunosuppressed Patients: A 7-Year Retrospective Cohort Study</title><title>Infection and Drug Resistance</title><description>Purpose: Carbapenem-resistant Gram-negative bacteria bloodstream infection (CRGNB-BSI) has gradually become a major threat worldwide due to its treatment difficulty and high mortality. This study aimed to determine the risk factors for CRGNB- BSI in immunosuppressed patients. Patients and Methods: A total of 427 immunosuppressed patients with CRGNB-BSI were retrospectively investigated from 2015 to 2021. Both univariate and multivariate logistic regression analyses were applied to evaluate independent risk factors for CRGNB-BSI. Results: The most common etiology was Klebsiella Pneumoniae (50.59%; 216/427), while the Acinetobacillus baumannii infection was associated with the highest mortality (58.25%) among all etiologies. The 60-day mortality of immunosuppressed patients with CRGNB-BSI was 52.48% (224/427). Procalcitonin (PCT) > 0.5 [micro]g/L (OR = 2.32, 95% CI: 1.28-4.19, P = 0.005) and age > 55 years (OR = 2.06, 95% CI: 1.17-3.64, P = 0.012) were found to be predictors of 60-day mortality of CRGNB-BSI, and tigecycline regimen (OR = 3.20, 95% CI: 1.81-5.67, P < 0.001) was associated with higher mortality. Multivariate analysis also revealed that patients who developed acute kidney injury (AKI) (OR = 2.19, 95% CI: 1.11-4.30, P = 0.023), gastrointestinal bleeding (OR = 3.18, 95% CI: 1.109.16, P = 0.032), multiple organ dysfunction syndrome (MODS) (OR = 12.11, 95% CI: 2.61-56.19, P = 0.001), and septic shock (OR = 3.24, 95% CI: 1.77-5.94, P < 0.001) showed worse outcomes. The risk factors were also significantly associated with mortality in the different subgroups. Conclusion: This study demonstrated that PCT > 0.5 [micro]g/L, age > 55 years, and the tigecycline regimen were significantly associated with higher 60-day mortality among immunosuppressed patients with CRGNB- BSI. Patients developing MODS, septic shock, or AKI had worse clinical outcomes. Keywords: bloodstream infection, carbapenem-resistant, immunosuppressed patients, subgroups, prognosis</description><subject>China</subject><subject>Development and progression</subject><subject>Gram-negative bacteria</subject><subject>Health aspects</subject><subject>Imipenem</subject><subject>Infection</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>Risk factors</subject><subject>Septic shock</subject><issn>1178-6973</issn><issn>1178-6973</issn><fulltext>true</fulltext><rsrctype>report</rsrctype><creationdate>2022</creationdate><recordtype>report</recordtype><sourceid/><recordid>eNqVjE1OwzAQRi0EEhV0xQXmAgn5U9yyawOl2aAqZcMKmWQSDLEn8jhIXIazYiQWbJlZzKdP854QV2kSZ2khr-vbJj7mqzIvshOxSFO5isq1zE__5HOxZH5LwuTrspDZQnwdHA2W2OsWGs3vsFOtJ8dAPVTKvagJLZqoQdbslfVw75SJHnBQXn8gbMM3Oq1gOxJ17B0qA7XtsfWaLGgLtTFz8M_T5JAZOzgEEq3nG9iAjJ5QOWjQO-LpBwrOil7JeTj6ufu8FGe9GhmXv_dCxLu7x2ofDWrEZ2178k61YTs0uiWLvQ79RuZpUiRJWeb_Br4Be6RqdA</recordid><startdate>20221130</startdate><enddate>20221130</enddate><creator>Gao, Yulian</creator><creator>Lin, Hongxia</creator><creator>Xu, Yumin</creator><creator>Yao, Yijin</creator><creator>Shi, Dake</creator><creator>Li, Junjie</creator><creator>Zhu, Haixing</creator><creator>Summah, Hanssa Dwarka</creator><creator>Ni, Lei</creator><creator>Feng, Yun</creator><general>Dove Medical Press Limited</general><scope/></search><sort><creationdate>20221130</creationdate><title>Prognostic Risk Factors of Carbapenem-Resistant Gram-Negative Bacteria Bloodstream Infection in Immunosuppressed Patients: A 7-Year Retrospective Cohort Study</title><author>Gao, Yulian ; Lin, Hongxia ; Xu, Yumin ; Yao, Yijin ; Shi, Dake ; Li, Junjie ; Zhu, Haixing ; Summah, Hanssa Dwarka ; Ni, Lei ; Feng, Yun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-gale_infotracacademiconefile_A7310400663</frbrgroupid><rsrctype>reports</rsrctype><prefilter>reports</prefilter><language>eng</language><creationdate>2022</creationdate><topic>China</topic><topic>Development and progression</topic><topic>Gram-negative bacteria</topic><topic>Health aspects</topic><topic>Imipenem</topic><topic>Infection</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>Risk factors</topic><topic>Septic shock</topic><toplevel>online_resources</toplevel><creatorcontrib>Gao, Yulian</creatorcontrib><creatorcontrib>Lin, Hongxia</creatorcontrib><creatorcontrib>Xu, Yumin</creatorcontrib><creatorcontrib>Yao, Yijin</creatorcontrib><creatorcontrib>Shi, Dake</creatorcontrib><creatorcontrib>Li, Junjie</creatorcontrib><creatorcontrib>Zhu, Haixing</creatorcontrib><creatorcontrib>Summah, Hanssa Dwarka</creatorcontrib><creatorcontrib>Ni, Lei</creatorcontrib><creatorcontrib>Feng, Yun</creatorcontrib></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gao, Yulian</au><au>Lin, Hongxia</au><au>Xu, Yumin</au><au>Yao, Yijin</au><au>Shi, Dake</au><au>Li, Junjie</au><au>Zhu, Haixing</au><au>Summah, Hanssa Dwarka</au><au>Ni, Lei</au><au>Feng, Yun</au><format>book</format><genre>unknown</genre><ristype>RPRT</ristype><atitle>Prognostic Risk Factors of Carbapenem-Resistant Gram-Negative Bacteria Bloodstream Infection in Immunosuppressed Patients: A 7-Year Retrospective Cohort Study</atitle><jtitle>Infection and Drug Resistance</jtitle><date>2022-11-30</date><risdate>2022</risdate><volume>15</volume><spage>6451</spage><pages>6451-</pages><issn>1178-6973</issn><eissn>1178-6973</eissn><abstract>Purpose: Carbapenem-resistant Gram-negative bacteria bloodstream infection (CRGNB-BSI) has gradually become a major threat worldwide due to its treatment difficulty and high mortality. This study aimed to determine the risk factors for CRGNB- BSI in immunosuppressed patients. Patients and Methods: A total of 427 immunosuppressed patients with CRGNB-BSI were retrospectively investigated from 2015 to 2021. Both univariate and multivariate logistic regression analyses were applied to evaluate independent risk factors for CRGNB-BSI. Results: The most common etiology was Klebsiella Pneumoniae (50.59%; 216/427), while the Acinetobacillus baumannii infection was associated with the highest mortality (58.25%) among all etiologies. The 60-day mortality of immunosuppressed patients with CRGNB-BSI was 52.48% (224/427). Procalcitonin (PCT) > 0.5 [micro]g/L (OR = 2.32, 95% CI: 1.28-4.19, P = 0.005) and age > 55 years (OR = 2.06, 95% CI: 1.17-3.64, P = 0.012) were found to be predictors of 60-day mortality of CRGNB-BSI, and tigecycline regimen (OR = 3.20, 95% CI: 1.81-5.67, P < 0.001) was associated with higher mortality. Multivariate analysis also revealed that patients who developed acute kidney injury (AKI) (OR = 2.19, 95% CI: 1.11-4.30, P = 0.023), gastrointestinal bleeding (OR = 3.18, 95% CI: 1.109.16, P = 0.032), multiple organ dysfunction syndrome (MODS) (OR = 12.11, 95% CI: 2.61-56.19, P = 0.001), and septic shock (OR = 3.24, 95% CI: 1.77-5.94, P < 0.001) showed worse outcomes. The risk factors were also significantly associated with mortality in the different subgroups. Conclusion: This study demonstrated that PCT > 0.5 [micro]g/L, age > 55 years, and the tigecycline regimen were significantly associated with higher 60-day mortality among immunosuppressed patients with CRGNB- BSI. Patients developing MODS, septic shock, or AKI had worse clinical outcomes. Keywords: bloodstream infection, carbapenem-resistant, immunosuppressed patients, subgroups, prognosis</abstract><pub>Dove Medical Press Limited</pub><doi>10.2147/IDR.S386342</doi></addata></record> |
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| source | Taylor & Francis Open Access; DOVE Medical Press Journals; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | China Development and progression Gram-negative bacteria Health aspects Imipenem Infection Medical research Medicine, Experimental Mortality Risk factors Septic shock |
| title | Prognostic Risk Factors of Carbapenem-Resistant Gram-Negative Bacteria Bloodstream Infection in Immunosuppressed Patients: A 7-Year Retrospective Cohort Study |
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