Objective: Pseudomonas aeruginosa bloodstream infection presents a severe challenge to hospitalized patients. To investigate the clinical characteristics, risk factors and drug resistance of Pseudomonas aeruginosa blo...Objective: Pseudomonas aeruginosa bloodstream infection presents a severe challenge to hospitalized patients. To investigate the clinical characteristics, risk factors and drug resistance of Pseudomonas aeruginosa bloodstream infection. Methods: Clinical data and laboratory results of patients with Pseudomonas aeruginosa bloodstream infection in the First Affiliated Hospital of Yangtze University from January 2019 to December 2022 were retrospectively analyzed. The factors associated with infection and death were analyzed by univariate analysis. Results: A total of 55 patients were enrolled in this study, The 28-day mortality rate was 14.5%. Univariate analysis showed that high procalcitonin, low albumin, ICU admission, central venous catheterization, indwelling catheter, and mechanical ventilation were associated with death. Multivariate Logistic regression analysis showed that hypoproteinemia and central venous catheters were independent risk factors for death in patients with Pseudomonas aeruginosa bloodstream infection. Conclusions: The drug resistance of P. aeruginosa bloodstream infection is not high, but the fatality rate is high. The combination of hypoalbuminemia after the onset of the disease and the use of central vein catheters can lead to increased mortality, suggesting that clinical identification of high-risk patients as early as possible, reducing the use of catheters, preventing the occurrence of P. aeruginosa bloodstream infection and improving the prognosis.展开更多
In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and...In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis（E.faecalis）,24 by Enterococcus faecium（E.faecium）,1 by Enterococcus casseliflavus（E.casseliflavus）,and 1 by Enterococcus gallinarum（E.gallinarum）.A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients（P=0.017,P=0.027,P=0.008 and P=0.027,respectively）.Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment（OR=17.385,P=0.008）,hospital acquisition（OR=16.328,P=0.038）,and vascular catheter infection（OR=14.788,P=0.025） were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.展开更多
BACKGROUND:Community-acquired bloodstream infections(CABSIs)are common in the emergency departments,and some progress to sepsis and even lead to death.However,limited information is available regarding the prediction ...BACKGROUND:Community-acquired bloodstream infections(CABSIs)are common in the emergency departments,and some progress to sepsis and even lead to death.However,limited information is available regarding the prediction of patients with high risk of death.METHODS:The Emergency Bloodstream Infection Score(EBS)for CABSIs was developed to visualize the output of a logistic regression model and was validated by the area under the curve(AUC).The Mortality in Emergency Department Sepsis(MEDS),Pitt Bacteremia Score(PBS),Sequential Organ Failure Assessment(SOFA),quick Sequential Organ Failure Assessment(qSOFA),Charlson Comorbidity Index(CCI),and McCabe–Jackson Comorbid Classification(MJCC)for patients with CABSIs were computed to compare them with EBS in terms of the AUC and decision curve analysis(DCA).The net reclassification improvement(NRI)index and integrated discrimination improvement(IDI)index were compared between the SOFA and EBS.RESULTS:A total of 547 patients with CABSIs were included.The AUC(0.853)of the EBS was larger than those of the MEDS,PBS,SOFA,and qSOFA(all P<0.001).The NRI index of EBS in predicting the in-hospital mortality of CABSIs patients was 0.368(P=0.04),and the IDI index was 0.079(P=0.03).DCA showed that when the threshold probability was<0.1,the net benefit of the EBS model was higher than those of the other models.CONCLUSION:The EBS prognostic models were better than the SOFA,qSOFA,MEDS,and PBS models in predicting the in-hospital mortality of patients with CABSIs.展开更多
文摘Objective: Pseudomonas aeruginosa bloodstream infection presents a severe challenge to hospitalized patients. To investigate the clinical characteristics, risk factors and drug resistance of Pseudomonas aeruginosa bloodstream infection. Methods: Clinical data and laboratory results of patients with Pseudomonas aeruginosa bloodstream infection in the First Affiliated Hospital of Yangtze University from January 2019 to December 2022 were retrospectively analyzed. The factors associated with infection and death were analyzed by univariate analysis. Results: A total of 55 patients were enrolled in this study, The 28-day mortality rate was 14.5%. Univariate analysis showed that high procalcitonin, low albumin, ICU admission, central venous catheterization, indwelling catheter, and mechanical ventilation were associated with death. Multivariate Logistic regression analysis showed that hypoproteinemia and central venous catheters were independent risk factors for death in patients with Pseudomonas aeruginosa bloodstream infection. Conclusions: The drug resistance of P. aeruginosa bloodstream infection is not high, but the fatality rate is high. The combination of hypoalbuminemia after the onset of the disease and the use of central vein catheters can lead to increased mortality, suggesting that clinical identification of high-risk patients as early as possible, reducing the use of catheters, preventing the occurrence of P. aeruginosa bloodstream infection and improving the prognosis.
基金funded by Shenzhen Scientific Research Program(No.JCYJ20150402152130173)Scientific Research Project of Shenzhen Health and Family Planning System(No.201601058)Scientific Research Program of Shenzhen Nanshan District of China(No.2015019,2015022,2016010)
文摘In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis（E.faecalis）,24 by Enterococcus faecium（E.faecium）,1 by Enterococcus casseliflavus（E.casseliflavus）,and 1 by Enterococcus gallinarum（E.gallinarum）.A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients（P=0.017,P=0.027,P=0.008 and P=0.027,respectively）.Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment（OR=17.385,P=0.008）,hospital acquisition（OR=16.328,P=0.038）,and vascular catheter infection（OR=14.788,P=0.025） were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.
基金supported by the National Key Research and Development Program of China(2021YFC2501800)。
文摘BACKGROUND:Community-acquired bloodstream infections(CABSIs)are common in the emergency departments,and some progress to sepsis and even lead to death.However,limited information is available regarding the prediction of patients with high risk of death.METHODS:The Emergency Bloodstream Infection Score(EBS)for CABSIs was developed to visualize the output of a logistic regression model and was validated by the area under the curve(AUC).The Mortality in Emergency Department Sepsis(MEDS),Pitt Bacteremia Score(PBS),Sequential Organ Failure Assessment(SOFA),quick Sequential Organ Failure Assessment(qSOFA),Charlson Comorbidity Index(CCI),and McCabe–Jackson Comorbid Classification(MJCC)for patients with CABSIs were computed to compare them with EBS in terms of the AUC and decision curve analysis(DCA).The net reclassification improvement(NRI)index and integrated discrimination improvement(IDI)index were compared between the SOFA and EBS.RESULTS:A total of 547 patients with CABSIs were included.The AUC(0.853)of the EBS was larger than those of the MEDS,PBS,SOFA,and qSOFA(all P<0.001).The NRI index of EBS in predicting the in-hospital mortality of CABSIs patients was 0.368(P=0.04),and the IDI index was 0.079(P=0.03).DCA showed that when the threshold probability was<0.1,the net benefit of the EBS model was higher than those of the other models.CONCLUSION:The EBS prognostic models were better than the SOFA,qSOFA,MEDS,and PBS models in predicting the in-hospital mortality of patients with CABSIs.
