Nosocomial bacteremia caused by antibiotic-resistant gram-negative bacteria in critically ill patients: Clinical outcome and length of hospitalization

被引:177
作者
Blot, S
Vandewoude, K
De Bacquer, D
Colardyn, F
机构
[1] Ghent Univ Hosp, Dept Intens Care, B-9000 Ghent, Belgium
[2] Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium
关键词
D O I
10.1086/340616
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 [免疫学];
摘要
Population characteristics and outcomes were retrospectively compared for critically ill patients with nosocomial bacteremia caused by antibiotic-susceptible (AB-S; n = 208) or antibiotic-resistant (AB-R; n = 120) gram-negative bacteria. No significant differences in severity of illness and comorbidity factors were seen between groups. Patients with bacteremia caused by AB-R strains had a longer hospitalization before the onset of the bacteremia. The in-hospital mortality for patients with bacteremia caused by AB-S strains was 41.8%; for patients infected with AB-R strains, it was 45.0% (P = .576). A multivariate survival analysis demonstrated that older age (P = .009), a high-risk source of bacteremia (abdominal and lower respiratory tract; P = .031), and a high acute physiology and chronic health evaluation II-related expected mortality (P = .032) were independently associated with in-hospital mortality (P<.05). Antibiotic resistance in nosocomial bacteremia caused by gram-negative bacteria does not adversely affect the outcome for critically ill patients.
引用
收藏
页码:1600 / 1606
页数:7
相关论文
共 27 条
[1]
[Anonymous], M2A5 NCCLS
[2]
Endemicity, molecular diversity and colonisation routes of Pseudomonas aeruginosa in intensive care units [J].
Bertrand, X ;
Thouverez, M ;
Talon, D ;
Boillot, A ;
Capellier, G ;
Floriot, C ;
Hélias, JP .
INTENSIVE CARE MEDICINE, 2001, 27 (08) :1263-1268
[3]
A nationwide, multicenter, case-control study comparing risk factors, treatment, and outcome for vancomycin-resistant and -susceptible enterococcal bacteremia [J].
Bhavnani, SM ;
Drake, JA ;
Forrest, A ;
Deinhart, JA ;
Jones, RN ;
Biedenbach, DJ ;
Ballow, CH .
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2000, 36 (03) :145-158
[4]
Blot S, 1998, NEW ENGL J MED, V339, P2025
[5]
PSEUDOMONAS BACTEREMIA - RETROSPECTIVE ANALYSIS OF 410 EPISODES [J].
BODEY, GP ;
JADEJA, L ;
ELTING, L .
ARCHIVES OF INTERNAL MEDICINE, 1985, 145 (09) :1621-1629
[6]
CEFTAZIDIME RESISTANCE AMONG SELECTED NOSOCOMIAL GRAM-NEGATIVE BACILLI IN THE UNITED-STATES [J].
BURWEN, DR ;
BANERJEE, SN ;
GAYNES, RP .
JOURNAL OF INFECTIOUS DISEASES, 1994, 170 (06) :1622-1625
[7]
Health and economic outcomes of antibiotic resistance in Pseudomonas aeruginosa [J].
Carmeli, Y ;
Troillet, N ;
Karchmer, AW ;
Samore, MH .
ARCHIVES OF INTERNAL MEDICINE, 1999, 159 (10) :1127-1132
[8]
ENTEROBACTER BACTEREMIA - CLINICAL-FEATURES AND EMERGENCE OF ANTIBIOTIC-RESISTANCE DURING THERAPY [J].
CHOW, JW ;
FINE, MJ ;
SHLAES, DM ;
QUINN, JP ;
HOOPER, DC ;
JOHNSON, MP ;
RAMPHAL, R ;
WAGENER, MM ;
MIYASHIRO, DK ;
YU, VL .
ANNALS OF INTERNAL MEDICINE, 1991, 115 (08) :585-590
[9]
COLARDYN F, 1997, 37 INT C ANT AG CHEM, P365
[10]
Antibiotic susceptibility among aerobic gram-negative bacilli in intensive care units in 5 European countries [J].
Hanberger, H ;
Garcia-Rodriguez, JA ;
Gobernado, M ;
Goossens, H ;
Nilsson, LE ;
Struelens, MJ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 281 (01) :67-71