Bloodstream infections in ICU with increased resistance: epidemiology and outcomes

Dimopoulos, G., Koulenti, D., Tabah, A., Poulakou, G., Vesin, A., Arvaniti, K., Lathyris, D., Matthaiou, D. K., Armaganidis, A. and Timsit, J. F. (2015) Bloodstream infections in ICU with increased resistance: epidemiology and outcomes. Minerva Anestesiologica, 81 4: 405-418.

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Name Description MIMEType Size Downloads
Author Dimopoulos, G.
Koulenti, D.
Tabah, A.
Poulakou, G.
Vesin, A.
Arvaniti, K.
Lathyris, D.
Matthaiou, D. K.
Armaganidis, A.
Timsit, J. F.
Title Bloodstream infections in ICU with increased resistance: epidemiology and outcomes
Journal name Minerva Anestesiologica   Check publisher's open access policy
ISSN 0375-9393
1827-1596
Publication date 2015-04-01
Sub-type Article (original research)
Volume 81
Issue 4
Start page 405
End page 418
Total pages 14
Place of publication Turin, Italy
Publisher Edizioni Minerva Medica
Collection year 2016
Language eng
Formatted abstract
Background: Aim of this study was to evaluate the epidemiology and outcomes of hospital-acquired bloodstream infections (HA-BSI) in Greek intensive care units (ICU).

Methods: Secondary analysis of data from 29 ICU collected during the EUROBACT study, a large prospective, observational, multination survey of HA-BSI. First episodes of HA-BSI acquired in the ICU or within 48 hours prior to admission were recorded.

Results: Gram-negative bacteria predominated namely Acinetobacter sp, Klebsiella sp, Pseudomonas sp (73.3% of monomicrobial infections) followed by Gram-positive cocci (18.3%); fungi (7.6%) and anaerobes (0.8%). Overall 73.3% of isolates were multidrug resistant (MDR), 47.1% extensively resistant (XDR) and 1.2% pan-drug resistant (PDR). Carbapenems were the most frequent empirically prescribed antibiotics, while colistin was the most frequently adequate; for both, calculated mean total daily doses were suboptimal. Overall 28-day all-cause mortality was 33.3%. In the multivariate analysis, factors adversely affecting outcome were higher SOFA score at HA-BSI onset (OR 1.19; 95% CI 1.08-1.31, P=0.0006), need for renal supportive therapy (OR 2.75; 95% CI 1.35-5.59, P=0.0053), and for vasopressors/inotropes (OR 2.68; CI 1.18-6.12, P=0.02); adequate empirical treatment had a protective effect (OR 0.48; CI 0.24-0.95, P=0.03).

Conclusion: Timely administration of adequately dosed treatment regimens and early ICU admission of critically ill patients could help in improving outcomes.
Keyword Bacteremia
Cross infection
Drug resistance, multiple
Outcomes
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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