Evaluation of early clinical failure criteria in Enterococcus species bloodstream infection
Purpose Early clinical failure criteria (ECFC) were recently introduced to predict unfavorable outcomes in patients with Gram-negative bloodstream infections (BSI). ECFC include hypotension, tachycardia, tachypnea or mechanical ventilation, altered mental status, and leukocytosis evaluated at 72–96 ...
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| Veröffentlicht in: | Infection 2022-08, Vol.50 (4), p.873-877 |
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| creator | Powers, Caroline E. Bookstaver, P. Brandon Caulder, Celeste Bouknight, Abigail Justo, Julie Ann Kohn, Joseph Winders, Hana Rac Al-Hasan, Majdi N. |
| description | Purpose
Early clinical failure criteria (ECFC) were recently introduced to predict unfavorable outcomes in patients with Gram-negative bloodstream infections (BSI). ECFC include hypotension, tachycardia, tachypnea or mechanical ventilation, altered mental status, and leukocytosis evaluated at 72–96 h after BSI. The aim of this retrospective cohort study was to assess performance of ECFC in predicting 28-day mortality in
Enterococcus
species BSI.
Methods
Hospitalized adults with
Enterococcus
species BSI at Prisma Health hospitals from 1 January 2015 to 31 July 2018 were identified. Multivariate logistic regression was used to determine the association between ECFC and 28-day mortality. Area under the receiver operating characteristic (AUROC) curve was used to measure model discrimination.
Results
Among 157 patients, 28 (18%) died within 28 days of BSI. After adjustments in multivariate model, the risk of 28-day mortality increased in the presence of each additional ECFC (OR 1.6, 95% CI 1.2–2.3,
p
= 0.005). Infective endocarditis (OR 3.9, 95% CI 1.4–10.7,
p
= 0.01) was independently associated with 28-day mortality. AUROC curve of ECFC model in predicting 28-day mortality was 0.74 with ECFC of 2 identified as the best breakpoint. Mortality was 8% in patients with ECFC |
| doi_str_mv | 10.1007/s15010-022-01754-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2621258099</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2696334112</sourcerecordid><originalsourceid>FETCH-LOGICAL-c305t-3208c7fe897dc72cad432cef759a0553a77e5858c3f7e3c355b81e88d90e38ff3</originalsourceid><addsrcrecordid>eNp9kE2LFDEQhoMo7rj6BzxIwIuX1krS6SRHWcYPWPCiJw8hU12RLJnOmHQL--_NOquCB09VUE-9VTyMPRfwWgCYN01oEDCAlAMIo8dhesB2YlRuAGfUQ7YDBTBYIacL9qS1GwDQbjSP2YXSMI6TUjv2df8j5C2sqSy8RE6h5luOOS0JQ-YxpLxV4ljTSjUFnha-X3pbsCBujbcTYaLGD7mUua2VwrEzkfAu8Cl7FENu9Oy-XrIv7_afrz4M15_ef7x6ez2gAr0OSoJFE8k6M6ORGOZRSaRotAugtQrGkLbaooqGFCqtD1aQtbMDUjZGdclenXNPtXzfqK3-mBpSzmGhsjUvJymktuBcR1_-g96UrS79u065bmQUQnZKnimspbVK0Z9qOoZ66wX4O_X-rN539f6Xej_1pRf30dvhSPOfld-uO6DOQOuj5RvVv7f_E_sTOXiO_Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2696334112</pqid></control><display><type>article</type><title>Evaluation of early clinical failure criteria in Enterococcus species bloodstream infection</title><source>SpringerNature Journals</source><creator>Powers, Caroline E. ; Bookstaver, P. Brandon ; Caulder, Celeste ; Bouknight, Abigail ; Justo, Julie Ann ; Kohn, Joseph ; Winders, Hana Rac ; Al-Hasan, Majdi N.</creator><creatorcontrib>Powers, Caroline E. ; Bookstaver, P. Brandon ; Caulder, Celeste ; Bouknight, Abigail ; Justo, Julie Ann ; Kohn, Joseph ; Winders, Hana Rac ; Al-Hasan, Majdi N.</creatorcontrib><description>Purpose
Early clinical failure criteria (ECFC) were recently introduced to predict unfavorable outcomes in patients with Gram-negative bloodstream infections (BSI). ECFC include hypotension, tachycardia, tachypnea or mechanical ventilation, altered mental status, and leukocytosis evaluated at 72–96 h after BSI. The aim of this retrospective cohort study was to assess performance of ECFC in predicting 28-day mortality in
Enterococcus
species BSI.
Methods
Hospitalized adults with
Enterococcus
species BSI at Prisma Health hospitals from 1 January 2015 to 31 July 2018 were identified. Multivariate logistic regression was used to determine the association between ECFC and 28-day mortality. Area under the receiver operating characteristic (AUROC) curve was used to measure model discrimination.
Results
Among 157 patients, 28 (18%) died within 28 days of BSI. After adjustments in multivariate model, the risk of 28-day mortality increased in the presence of each additional ECFC (OR 1.6, 95% CI 1.2–2.3,
p
= 0.005). Infective endocarditis (OR 3.9, 95% CI 1.4–10.7,
p
= 0.01) was independently associated with 28-day mortality. AUROC curve of ECFC model in predicting 28-day mortality was 0.74 with ECFC of 2 identified as the best breakpoint. Mortality was 8% in patients with ECFC < 2 compared to 33% in those with ECFC ≥ 2 (
p
< 0.001).
Conclusion
ECFC had good discrimination in predicting 28-day mortality in patients with
Enterococcus
species BSI. These criteria may have utility in future clinical investigations.</description><identifier>ISSN: 0300-8126</identifier><identifier>EISSN: 1439-0973</identifier><identifier>DOI: 10.1007/s15010-022-01754-6</identifier><identifier>PMID: 35044633</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Antibiotics ; Bacterial infections ; Clinical outcomes ; Criteria ; Endocarditis ; Enterococcus ; Family Medicine ; General Practice ; Hypotension ; Infectious Diseases ; Internal Medicine ; Leukocytosis ; Mechanical ventilation ; Medical prognosis ; Medicine ; Medicine & Public Health ; Mortality ; Multivariate analysis ; Original Paper ; Patients ; Performance assessment ; Species ; Tachycardia ; Tachypnea</subject><ispartof>Infection, 2022-08, Vol.50 (4), p.873-877</ispartof><rights>This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2022</rights><rights>2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.</rights><rights>This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c305t-3208c7fe897dc72cad432cef759a0553a77e5858c3f7e3c355b81e88d90e38ff3</citedby><cites>FETCH-LOGICAL-c305t-3208c7fe897dc72cad432cef759a0553a77e5858c3f7e3c355b81e88d90e38ff3</cites><orcidid>0000-0001-7341-0500</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s15010-022-01754-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s15010-022-01754-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35044633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Powers, Caroline E.</creatorcontrib><creatorcontrib>Bookstaver, P. Brandon</creatorcontrib><creatorcontrib>Caulder, Celeste</creatorcontrib><creatorcontrib>Bouknight, Abigail</creatorcontrib><creatorcontrib>Justo, Julie Ann</creatorcontrib><creatorcontrib>Kohn, Joseph</creatorcontrib><creatorcontrib>Winders, Hana Rac</creatorcontrib><creatorcontrib>Al-Hasan, Majdi N.</creatorcontrib><title>Evaluation of early clinical failure criteria in Enterococcus species bloodstream infection</title><title>Infection</title><addtitle>Infection</addtitle><addtitle>Infection</addtitle><description>Purpose
Early clinical failure criteria (ECFC) were recently introduced to predict unfavorable outcomes in patients with Gram-negative bloodstream infections (BSI). ECFC include hypotension, tachycardia, tachypnea or mechanical ventilation, altered mental status, and leukocytosis evaluated at 72–96 h after BSI. The aim of this retrospective cohort study was to assess performance of ECFC in predicting 28-day mortality in
Enterococcus
species BSI.
Methods
Hospitalized adults with
Enterococcus
species BSI at Prisma Health hospitals from 1 January 2015 to 31 July 2018 were identified. Multivariate logistic regression was used to determine the association between ECFC and 28-day mortality. Area under the receiver operating characteristic (AUROC) curve was used to measure model discrimination.
Results
Among 157 patients, 28 (18%) died within 28 days of BSI. After adjustments in multivariate model, the risk of 28-day mortality increased in the presence of each additional ECFC (OR 1.6, 95% CI 1.2–2.3,
p
= 0.005). Infective endocarditis (OR 3.9, 95% CI 1.4–10.7,
p
= 0.01) was independently associated with 28-day mortality. AUROC curve of ECFC model in predicting 28-day mortality was 0.74 with ECFC of 2 identified as the best breakpoint. Mortality was 8% in patients with ECFC < 2 compared to 33% in those with ECFC ≥ 2 (
p
< 0.001).
Conclusion
ECFC had good discrimination in predicting 28-day mortality in patients with
Enterococcus
species BSI. These criteria may have utility in future clinical investigations.</description><subject>Antibiotics</subject><subject>Bacterial infections</subject><subject>Clinical outcomes</subject><subject>Criteria</subject><subject>Endocarditis</subject><subject>Enterococcus</subject><subject>Family Medicine</subject><subject>General Practice</subject><subject>Hypotension</subject><subject>Infectious Diseases</subject><subject>Internal Medicine</subject><subject>Leukocytosis</subject><subject>Mechanical ventilation</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Original Paper</subject><subject>Patients</subject><subject>Performance assessment</subject><subject>Species</subject><subject>Tachycardia</subject><subject>Tachypnea</subject><issn>0300-8126</issn><issn>1439-0973</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE2LFDEQhoMo7rj6BzxIwIuX1krS6SRHWcYPWPCiJw8hU12RLJnOmHQL--_NOquCB09VUE-9VTyMPRfwWgCYN01oEDCAlAMIo8dhesB2YlRuAGfUQ7YDBTBYIacL9qS1GwDQbjSP2YXSMI6TUjv2df8j5C2sqSy8RE6h5luOOS0JQ-YxpLxV4ljTSjUFnha-X3pbsCBujbcTYaLGD7mUua2VwrEzkfAu8Cl7FENu9Oy-XrIv7_afrz4M15_ef7x6ez2gAr0OSoJFE8k6M6ORGOZRSaRotAugtQrGkLbaooqGFCqtD1aQtbMDUjZGdclenXNPtXzfqK3-mBpSzmGhsjUvJymktuBcR1_-g96UrS79u065bmQUQnZKnimspbVK0Z9qOoZ66wX4O_X-rN539f6Xej_1pRf30dvhSPOfld-uO6DOQOuj5RvVv7f_E_sTOXiO_Q</recordid><startdate>20220801</startdate><enddate>20220801</enddate><creator>Powers, Caroline E.</creator><creator>Bookstaver, P. Brandon</creator><creator>Caulder, Celeste</creator><creator>Bouknight, Abigail</creator><creator>Justo, Julie Ann</creator><creator>Kohn, Joseph</creator><creator>Winders, Hana Rac</creator><creator>Al-Hasan, Majdi N.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7341-0500</orcidid></search><sort><creationdate>20220801</creationdate><title>Evaluation of early clinical failure criteria in Enterococcus species bloodstream infection</title><author>Powers, Caroline E. ; Bookstaver, P. Brandon ; Caulder, Celeste ; Bouknight, Abigail ; Justo, Julie Ann ; Kohn, Joseph ; Winders, Hana Rac ; Al-Hasan, Majdi N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-3208c7fe897dc72cad432cef759a0553a77e5858c3f7e3c355b81e88d90e38ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antibiotics</topic><topic>Bacterial infections</topic><topic>Clinical outcomes</topic><topic>Criteria</topic><topic>Endocarditis</topic><topic>Enterococcus</topic><topic>Family Medicine</topic><topic>General Practice</topic><topic>Hypotension</topic><topic>Infectious Diseases</topic><topic>Internal Medicine</topic><topic>Leukocytosis</topic><topic>Mechanical ventilation</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Original Paper</topic><topic>Patients</topic><topic>Performance assessment</topic><topic>Species</topic><topic>Tachycardia</topic><topic>Tachypnea</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Powers, Caroline E.</creatorcontrib><creatorcontrib>Bookstaver, P. Brandon</creatorcontrib><creatorcontrib>Caulder, Celeste</creatorcontrib><creatorcontrib>Bouknight, Abigail</creatorcontrib><creatorcontrib>Justo, Julie Ann</creatorcontrib><creatorcontrib>Kohn, Joseph</creatorcontrib><creatorcontrib>Winders, Hana Rac</creatorcontrib><creatorcontrib>Al-Hasan, Majdi N.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Powers, Caroline E.</au><au>Bookstaver, P. Brandon</au><au>Caulder, Celeste</au><au>Bouknight, Abigail</au><au>Justo, Julie Ann</au><au>Kohn, Joseph</au><au>Winders, Hana Rac</au><au>Al-Hasan, Majdi N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of early clinical failure criteria in Enterococcus species bloodstream infection</atitle><jtitle>Infection</jtitle><stitle>Infection</stitle><addtitle>Infection</addtitle><date>2022-08-01</date><risdate>2022</risdate><volume>50</volume><issue>4</issue><spage>873</spage><epage>877</epage><pages>873-877</pages><issn>0300-8126</issn><eissn>1439-0973</eissn><abstract>Purpose
Early clinical failure criteria (ECFC) were recently introduced to predict unfavorable outcomes in patients with Gram-negative bloodstream infections (BSI). ECFC include hypotension, tachycardia, tachypnea or mechanical ventilation, altered mental status, and leukocytosis evaluated at 72–96 h after BSI. The aim of this retrospective cohort study was to assess performance of ECFC in predicting 28-day mortality in
Enterococcus
species BSI.
Methods
Hospitalized adults with
Enterococcus
species BSI at Prisma Health hospitals from 1 January 2015 to 31 July 2018 were identified. Multivariate logistic regression was used to determine the association between ECFC and 28-day mortality. Area under the receiver operating characteristic (AUROC) curve was used to measure model discrimination.
Results
Among 157 patients, 28 (18%) died within 28 days of BSI. After adjustments in multivariate model, the risk of 28-day mortality increased in the presence of each additional ECFC (OR 1.6, 95% CI 1.2–2.3,
p
= 0.005). Infective endocarditis (OR 3.9, 95% CI 1.4–10.7,
p
= 0.01) was independently associated with 28-day mortality. AUROC curve of ECFC model in predicting 28-day mortality was 0.74 with ECFC of 2 identified as the best breakpoint. Mortality was 8% in patients with ECFC < 2 compared to 33% in those with ECFC ≥ 2 (
p
< 0.001).
Conclusion
ECFC had good discrimination in predicting 28-day mortality in patients with
Enterococcus
species BSI. These criteria may have utility in future clinical investigations.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35044633</pmid><doi>10.1007/s15010-022-01754-6</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-7341-0500</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0300-8126 |
| ispartof | Infection, 2022-08, Vol.50 (4), p.873-877 |
| issn | 0300-8126 1439-0973 |
| language | eng |
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| source | SpringerNature Journals |
| subjects | Antibiotics Bacterial infections Clinical outcomes Criteria Endocarditis Enterococcus Family Medicine General Practice Hypotension Infectious Diseases Internal Medicine Leukocytosis Mechanical ventilation Medical prognosis Medicine Medicine & Public Health Mortality Multivariate analysis Original Paper Patients Performance assessment Species Tachycardia Tachypnea |
| title | Evaluation of early clinical failure criteria in Enterococcus species bloodstream infection |
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