鲍曼不动杆菌血流感染的死亡风险因素及死亡率预测模型的开发。

IF 3.7 3区 医学 Q2 INFECTIOUS DISEASES Journal of global antimicrobial resistance Pub Date : 2024-07-17 DOI:10.1016/j.jgar.2024.06.010
{"title":"鲍曼不动杆菌血流感染的死亡风险因素及死亡率预测模型的开发。","authors":"","doi":"10.1016/j.jgar.2024.06.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p><em>Acinetobacter baumannii</em> (<em>A. baumannii</em>) nosocomial infections represent a serious hazard to public health, given high mortality rates and rapid spread of multidrug-resistance. The primary outcome of this study was to evaluate predictors of 14- and 30-d mortality in bloodstream infections (BSIs) due to both carbapenem-resistant and carbapenem-sensitive <em>Acinetobacter.</em> Secondary end points were to identify risk factors for BSIs due to carbapenem-resistant <em>A. baumannii</em> (CRAB) and to develop a predictive model for mortality in CRAB-related BSIs.</p></div><div><h3>Methods</h3><p>Between 2019 and 2023, all consecutive hospitalized adult patients with bacteraemia due to <em>A. baumannii</em> were retrospectively enrolled at a single-centre<em>.</em></p></div><div><h3>Results</h3><p>One hundred twenty-six episodes of BSI caused by <em>A. baumannii</em> were recorded, 89.7% of which were due to CRAB. Recent burn injuries, older age, previous CRAB colonization, and antibiotics exposure were identified as risk factors for acquiring CRAB BSI. Overall, 14-d mortality was observed in 26.1% of the patients and 30-d mortality in 30.9% of the patients. On multivariate analysis, the Sequential Organ Failure Assessment (SOFA) score was associated with both 14- and 30-d mortality, whereas burn injuries correlated with 30-d survival. Concurrent coronavirus disease (COVID) was associated with mortality, although not reaching statistical figures. No major impact of receiving appropriate treatment was observed. Based on these findings, a multivariable model to predict mortality among patients with CRAB BSI was built and internally validated.</p></div><div><h3>Conclusions</h3><p><em>A. baumannii</em> BSIs are characterized by poor outcomes and limited therapeutic options. This study aimed to assist physicians in prompt identification of patients who are at greater risk of death, contributing to more informed clinical decision making.</p></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001255/pdfft?md5=85f8dfbe57eb332ca4389320273c36ca&pid=1-s2.0-S2213716524001255-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Risk factors for mortality in Acinetobacter baumannii bloodstream infections and development of a predictive mortality model\",\"authors\":\"\",\"doi\":\"10.1016/j.jgar.2024.06.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p><em>Acinetobacter baumannii</em> (<em>A. baumannii</em>) nosocomial infections represent a serious hazard to public health, given high mortality rates and rapid spread of multidrug-resistance. The primary outcome of this study was to evaluate predictors of 14- and 30-d mortality in bloodstream infections (BSIs) due to both carbapenem-resistant and carbapenem-sensitive <em>Acinetobacter.</em> Secondary end points were to identify risk factors for BSIs due to carbapenem-resistant <em>A. baumannii</em> (CRAB) and to develop a predictive model for mortality in CRAB-related BSIs.</p></div><div><h3>Methods</h3><p>Between 2019 and 2023, all consecutive hospitalized adult patients with bacteraemia due to <em>A. baumannii</em> were retrospectively enrolled at a single-centre<em>.</em></p></div><div><h3>Results</h3><p>One hundred twenty-six episodes of BSI caused by <em>A. baumannii</em> were recorded, 89.7% of which were due to CRAB. Recent burn injuries, older age, previous CRAB colonization, and antibiotics exposure were identified as risk factors for acquiring CRAB BSI. Overall, 14-d mortality was observed in 26.1% of the patients and 30-d mortality in 30.9% of the patients. On multivariate analysis, the Sequential Organ Failure Assessment (SOFA) score was associated with both 14- and 30-d mortality, whereas burn injuries correlated with 30-d survival. Concurrent coronavirus disease (COVID) was associated with mortality, although not reaching statistical figures. No major impact of receiving appropriate treatment was observed. Based on these findings, a multivariable model to predict mortality among patients with CRAB BSI was built and internally validated.</p></div><div><h3>Conclusions</h3><p><em>A. baumannii</em> BSIs are characterized by poor outcomes and limited therapeutic options. This study aimed to assist physicians in prompt identification of patients who are at greater risk of death, contributing to more informed clinical decision making.</p></div>\",\"PeriodicalId\":15936,\"journal\":{\"name\":\"Journal of global antimicrobial resistance\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-07-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2213716524001255/pdfft?md5=85f8dfbe57eb332ca4389320273c36ca&pid=1-s2.0-S2213716524001255-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of global antimicrobial resistance\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2213716524001255\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of global antimicrobial resistance","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213716524001255","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

摘要

背景:鲍曼不动杆菌院内感染对公共卫生构成严重危害,因为死亡率高且多重耐药性迅速蔓延:方法:2019 年至 2023 年期间,在一个单一中心对所有连续住院的鲍曼不动杆菌菌血症成人患者进行回顾性登记:主要结果是评估耐碳青霉烯类和对碳青霉烯类敏感的鲍曼不动杆菌引起的血流感染(BSI)14 天和 30 天死亡率的预测因素。次要终点是确定耐碳青霉烯类鲍曼不动杆菌(CRAB)所致BSI的风险因素,并建立CRAB相关BSI的死亡率预测模型:共记录了126例由鲍曼不动杆菌引起的BSI,其中89.7%是由耐碳青霉烯鲍曼不动杆菌引起的。近期烧伤、年龄较大、既往有CRAB定植和抗生素接触被认为是感染CRAB BSI的风险因素。总体而言,26.1%的患者在14天内死亡,30.9%的患者在30天内死亡。在多变量分析中,序贯器官衰竭评估(SOFA)评分与 14 天和 30 天死亡率相关,而烧伤与 30 天存活率相关。并发冠状病毒病(COVID)与死亡率有关,但未达到统计学水平。没有观察到接受适当治疗会产生重大影响。基于这些发现,我们建立了一个多变量模型来预测CRAB BSI患者的死亡率,并在内部进行了验证:结论:鲍曼不动杆菌 BSI 的特点是治疗效果差、治疗方案有限。本研究旨在帮助医生及时发现死亡风险较高的患者,从而做出更明智的临床决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Risk factors for mortality in Acinetobacter baumannii bloodstream infections and development of a predictive mortality model

Objectives

Acinetobacter baumannii (A. baumannii) nosocomial infections represent a serious hazard to public health, given high mortality rates and rapid spread of multidrug-resistance. The primary outcome of this study was to evaluate predictors of 14- and 30-d mortality in bloodstream infections (BSIs) due to both carbapenem-resistant and carbapenem-sensitive Acinetobacter. Secondary end points were to identify risk factors for BSIs due to carbapenem-resistant A. baumannii (CRAB) and to develop a predictive model for mortality in CRAB-related BSIs.

Methods

Between 2019 and 2023, all consecutive hospitalized adult patients with bacteraemia due to A. baumannii were retrospectively enrolled at a single-centre.

Results

One hundred twenty-six episodes of BSI caused by A. baumannii were recorded, 89.7% of which were due to CRAB. Recent burn injuries, older age, previous CRAB colonization, and antibiotics exposure were identified as risk factors for acquiring CRAB BSI. Overall, 14-d mortality was observed in 26.1% of the patients and 30-d mortality in 30.9% of the patients. On multivariate analysis, the Sequential Organ Failure Assessment (SOFA) score was associated with both 14- and 30-d mortality, whereas burn injuries correlated with 30-d survival. Concurrent coronavirus disease (COVID) was associated with mortality, although not reaching statistical figures. No major impact of receiving appropriate treatment was observed. Based on these findings, a multivariable model to predict mortality among patients with CRAB BSI was built and internally validated.

Conclusions

A. baumannii BSIs are characterized by poor outcomes and limited therapeutic options. This study aimed to assist physicians in prompt identification of patients who are at greater risk of death, contributing to more informed clinical decision making.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of global antimicrobial resistance
Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
8.70
自引率
2.20%
发文量
285
审稿时长
34 weeks
期刊介绍: The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.
期刊最新文献
Refining the gut colonization Zophobas morio larvae model using an oral administration of multidrug-resistant Escherichia coli. From Forgotten Cure to Modern Medicine: The Resurgence of Bacteriophage Therapy. Rapid immunochromatographic detection of carbapenemases directly from positive blood cultures in patients colonized by carbapenemase-producing bacteria. Study of the mechanisms of heteroresistance to colistin in a strain of Enterobacter cloacae by random mutagenesis. Integral genomic description of blaNDM-5-harbouring plasmids recovered from Enterobacterales in Argentina.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1