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Assessment of Mortality-Related Risk Factors and Effective Antimicrobial Regimens for Treatment of Bloodstream Infections Caused by Carbapenem-Resistant Enterobacterales.
Chen, Liang; Han, Xiudi; Li, YanLi; Li, Minghui.
Affiliation
  • Chen L; Department of Infectious Diseases, Nanjing Lishui People's Hospital, Nanjing City, China.
  • Han X; Department of Infectious Diseases, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China.
  • Li Y; Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao City, China.
  • Li M; Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Antimicrob Agents Chemother ; 65(9): e0069821, 2021 08 17.
Article in En | MEDLINE | ID: mdl-34228539
ABSTRACT
Bloodstream infections (BSIs) attributable to carbapenem-resistant Enterobacterales (CRE-BSIs) are dangerous and a major cause of mortality in clinical settings. This study was therefore designed to define risk factors linked to 30-day mortality in CRE-BSI patients and to examine the relative efficacies of different antimicrobial treatment regimens in affected individuals. Data pertaining to 187 CRE-BSI cases from four teaching hospitals in China collected between January 2018 and December 2020 were retrospectively analyzed. For the 187 patients analyzed in this study, the 30-day mortality of CRE-BSI was 41.7% (78/187). Multivariate logistic regression analyses revealed that Pitt bacteremia score, immunocompromised status, meropenem MIC of ≥8 mg/liter,absence of source control of infection, and appropriate empirical therapy were independent predictors of CRE-BSI patient 30-day mortality. After controlling for potential confounding factors relative to ceftazidime-avibactam (CAZ-AVI) treatment, combination therapies including CAZ-AVI (odds ratio [OR], 1.287; 95% confidence interval [CI], 0.124 to 13.403; P = 0.833) were not related to any significant change in patient mortality risk, whereas the 30-day mortality risk was higher for patients administered other antimicrobial regimens (OR, 12.407; 95% CI, 1.684 to 31.430; P = 0.011). When patients were treated with antimicrobial regimens not containing CAZ-AVI, combination therapy (OR, 0.239; 95% CI, 0.077 to 0.741; P = 0.013) was related to a decreased 30-day mortality risk relative to monotherapy treatment. The mortality-related risk factors and relative antimicrobial regimen efficacy data demonstrated in this study may guide the management of CRE-BSI patients.
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Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Plantas_medicinales Main subject: Bacteremia / Sepsis Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Antimicrob Agents Chemother Year: 2021 Type: Article Affiliation country: China

Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Plantas_medicinales Main subject: Bacteremia / Sepsis Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Antimicrob Agents Chemother Year: 2021 Type: Article Affiliation country: China