Nosocomial bacteremia caused by antibiotic-resistant gram-negative bacteria in critically ill patients: clinical outcome and length of hospitalization.
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.
Blot
Stijn
S
Department of Intensive Care, Ghent University Hospital, B-9000 Ghent, Belgium. stijn.blot@rug.ac.be
Vandewoude
Koenraad
K
De Bacquer
Dirk
D
Colardyn
Francis
F
D016470:Bacteremia / Q000382:microbiology* / Q000401:mortality; D015331:Cohort Studies; D016638:Critical Illness; D003428:Cross Infection / Q000382:microbiology* / Q000401:mortality; D004351:Drug Resistance; D006090:Gram-Negative Bacteria; D016905:Gram-Negative Bacterial Infections / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D016019:Survival Analysis