title: Healthcare-associated Gram-negative bloodstream infections: antibiotic resistance and predictors of mortality.
abstract: This article describes the prevalence of antibiotic resistance and predictors of mortality for healthcare-associated (HA) Gram-negative bloodstream infections (GN-BSI). In total, 831 cases of HA GN-BSI from 17 intensive care units in different centres in Turkey were included; the all-cause mortality rate was 44%. Carbapenem resistance in Klebsiella pneumoniae was 38%, and the colistin resistance rate was 6%. Multi-variate analysis showed that age >70 years [odds ratio (OR) 2, 95% confidence interval (CI) 1.22-3.51], central venous catheter use (OR 2.1, 95% CI 1.09-4.07), ventilator-associated pneumonia (OR 1.9, 95% CI 1.1-3.16), carbapenem resistance (OR 1.8, 95% CI 1.11-2.95) and APACHE II score (OR 1.1, 95% CI 1.07-1.13) were significantly associated with mortality.
authors.affiliation: Koç University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey. Electronic address: oergonul@ku.edu.tr.
authors.forename: Ö
authors.initials: Ö
authors.lastname: Ergönül
authors.affiliation: Başkent University School of Medicine, Istanbul Hospital, Infectious Diseases and Clinical Microbiology Department, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Aydin
authors.affiliation: Ankara University Medical Faculty, Infectious Diseases and Clinical Microbiology Department, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Azap
authors.affiliation: Istanbul University Istanbul Medical School, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Başaran
authors.affiliation: Koç University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Tekin
authors.affiliation: Diyarbakır Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Diyarbakır, Turkey.
authors.forename: Ş
authors.initials: Ş
authors.lastname: Kaya
authors.affiliation: Diyarbakır Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Diyarbakır, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Gülsün
authors.affiliation: Istanbul Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Yörük
authors.affiliation: Başkent University School of Medicine, Adana Hospital, Infectious Diseases and Clinical Microbiology Department, Adana, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Kurşun
authors.affiliation: Başkent University School of Medicine, Ankara Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Yeşilkaya
authors.affiliation: Okmeydanı Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Şimşek
authors.affiliation: Uludağ University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Bursa, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Yılmaz
authors.affiliation: Marmara University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Bilgin
authors.affiliation: Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey.
authors.forename: Ç
authors.initials: Ç
authors.lastname: Hatipoğlu
authors.affiliation: Ankara Specialty Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Cabadak
authors.affiliation: Ankara Specialty Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Tezer
authors.affiliation: Başkent University School of Medicine, Konya Hospital, Infectious Diseases and Clinical Microbiology Department, Konya, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Togan
authors.affiliation: Gaziantep University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Gaziantep, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Karaoğlan
authors.affiliation: Haydarpaşa Numune Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: İnan
authors.affiliation: Cumhuriyet University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Sivas, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Engin
authors.affiliation: Başkent University School of Medicine, Adana Hospital, Infectious Diseases and Clinical Microbiology Department, Adana, Turkey.
authors.forename: H E
authors.initials: HE
authors.lastname: Alışkan
authors.affiliation: Istanbul University Istanbul Medical School, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: S Ş
authors.initials: SŞ
authors.lastname: Yavuz
authors.affiliation: Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey.
authors.forename: Ş
authors.initials: Ş
authors.lastname: Erdinç
authors.affiliation: Marmara University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: L
authors.initials: L
authors.lastname: Mulazimoglu
authors.affiliation: Başkent University School of Medicine, Ankara Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey.
authors.forename: Ö
authors.initials: Ö
authors.lastname: Azap
authors.affiliation: Koç University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Can
authors.affiliation: Uludağ University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Bursa, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Akalın
authors.affiliation: Başkent University School of Medicine, Istanbul Hospital, Infectious Diseases and Clinical Microbiology Department, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Timurkaynak
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology
keywords: Bloodstream; Gram-negative; Healthcare