Shift in risk factors for mortality by period of the bloodstream infection timeline.
J Microbiol Immunol Infect
; 57(1): 97-106, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-38092626
ABSTRACT
BACKGROUND:
This study was designed to determine changes in risk factors on the prognosis of patients during each period of the bloodstream infection (BSI) timeline.METHODS:
Through an integrated study of multivariable regressions with machine learning techniques, the risk factors for mortality during each period of BSI were analyzed.RESULTS:
A total of 302,303 inpatients who underwent blood cultures during 2011-2021 were enrolled. More than 8 % of BSI cases progressed to subsequent BSI, and risk factors were identified as gut colonization with vancomycin-resistant enterococci (aOR 1.82; 95 % CI 1.47-2.24), intensive care unit admission (aOR 3.37; 95 % CI 3.35-4.28), and current cancer chemotherapy (aOR 1.54; 95 % CI 1.36-1.74). The mean SOFA score of the deceased patients during the first 7 days was 10.6 (SD 4.3), which was significantly higher than those on days 8-30 (7.0 ± 4.2) and after Day 30 (4.0 ± 3.5). BSIs caused by Acinetobacter baumannii and Candida albicans were more likely to result in deaths of patients for all time periods (all, P < 0.001). BSIs caused by Enterococcus faecalis and Enterococcus faecium were associated with a poor outcome in the period after Day 30 (both, P < 0.001). Nonsusceptible phenotypes to ß-lactam/ß-lactamase inhibitors of Escherichia coli and Klebsiella pneumoniae influenced the prognoses of patients with BSI in terms of high mortality rates during both days 8-30 and after Day 30.CONCLUSION:
Influence of microbiological factors on mortality, including BSI-causative microorganisms and their major antimicrobial resistance, was emphasized in both periods of days 8-30 and after Day 30.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Bacteriemia
/
Sepse
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Enterococos Resistentes à Vancomicina
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article