title: Clinical manifestations and prognostic factors of Morganella morganii bacteremia.
abstract: Although Morganella morganii causes a variety of clinical infections, there are limited studies on M. morganii bacteremia after the year 2000. A total of 109 patients with M. morganii bacteremia at a medical center in Taiwan from 2003 to 2012 were studied. Among them, 30.3 % had polymicrobial bacteremia and 75.2 % had community-acquired infection. The most common underlying diseases were hypertension (62.4 %) and diabetes mellitus (38.5 %). The urinary tract (41.3 %) was the major portal of entry, followed by the hepatobiliary tract (27.5 %), skin and soft tissue (21.1 %), and primary bacteremia (10.1 %). Susceptibility testing of M. morganii isolates showed ubiquitous resistance to first-generation cephalosporins and ampicillin-clavulanate; resistance rates to gentamicin, piperacillin-tazobactam, and ciprofloxacin were 30.3 %, 1.8 %, and 10.1 %, respectively. Overall, the 14-day mortality was 14.7 %. Univariate analysis revealed that elevated blood urea nitrogen (BUN) values [p = 0.0137, odds ratio (OR) 5.26], intensive care unit (ICU) admission (p = 0.011, OR 4.4), and higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (p < 0.001, OR 1.62) were significantly associated with mortality. The APACHE II score remained the only significant risk factor for mortality in multivariate analysis (p = 0.0012, OR 1.55). In conclusion, M. morganii bacteremia patients were mostly elderly, with one or more comorbidities. Most of the patients had community-acquired infection via the urinary and hepatobiliary tracts. Furthermore, prognosis can be predicted according to disease severity measured by the APACHE II score.
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Number 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.
authors.forename: T-Y
authors.initials: TY
authors.lastname: Lin
authors.forename: M-C
authors.initials: MC
authors.lastname: Chan
authors.forename: Y-S
authors.initials: YS
authors.lastname: Yang
authors.forename: Y
authors.initials: Y
authors.lastname: Lee
authors.forename: K-M
authors.initials: KM
authors.lastname: Yeh
authors.forename: J-C
authors.initials: JC
authors.lastname: Lin
authors.forename: F-Y
authors.initials: FY
authors.lastname: Chang
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D002511:Cephalosporins / Q000494:pharmacology; D017714:Community-Acquired Infections / Q000401:mortality; D003428:Cross Infection; D024881:Drug Resistance, Bacterial; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D005839:Gentamicins / Q000494:pharmacology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D020613:Morganella morganii / Q000187:drug effects / Q000302:isolation & purification*; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000494:pharmacology; D010878:Piperacillin / Q000494:pharmacology; D000077725:Piperacillin, Tazobactam Drug Combination; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005839:Gentamicins; D000077725:Piperacillin, Tazobactam Drug Combination; D000667:Ampicillin; D010397:Penicillanic Acid; D010878:Piperacillin
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