Characteristics and determinants of outcome of hospital-acquired bloodstream infections in intensive care units: the EUROBACT International Cohort Study

Tabah, Alexis; Koulenti, Despoina; Laupland, Kevin B.; Misset, Benoît; Vallès, Jordi; Carvalho, Frederico Bruzzi de; Paiva, José Artur; Çakar, Nahit; Ma, Xiaochun; Eggimann, Philippe; Antonelli, Massimo; Bonten, Marc J. M.; Csomós, Ákos; Krueger, Wolfgang A.; Mikstacki, Adam; Lipman, Jeffrey; Depuydt, Pieter; Vesin, Aurélien; Garrouste-Orgeas, Maïté; Zahar, Jean Ralph; Blot, Stijn; Carlet, Jean; Brun‐Buisson, Christian; Martin, Claude; Rello, Jordi; Dimopoulos, G.; Timsit, Jean François

doi:10.1007/s00134-012-2695-9

Cited by 363 publications

(343 citation statements)

References 36 publications

Supporting

Mentioning

290

Contrasting

Unclassified

Order By: Relevance

“…About 85.2% of them used the antibiotics before blood specimen collection, which was much higher than the 20% reported by a multi-center study and included the 1100 ICU patients with nBSIs (Tabah et al, 2012). However, compared with that study, the most frequent use of antibiotics for treating BSIs was the same; they were carbapenems and glycopeptides.…”

Section: Discussionmentioning

confidence: 67%

“…However, appropriate empirical therapy can protect patients from mortality at 28 d. The mortality rate was reduced by approximately 4-fold in patients receiving appropriate empirical therapy compared to those without (OR=0.23, P=0.001). As shown in other studies, appropriate empirical antibiotic treatment has been known to be the most effective treatment for BSIs (Sogaard et al, 2011) and inappropriate empirical antibiotic therapy has been one of the most important risk factors for mortality in nBSIs (Tabah et al, 2012). Therefore, how to improve the empirical use of antibiotics in the early period of BSIs in order to reduce the 28-d mortality in our hospital should be elaborated in future studies.…”

Section: Discussionmentioning

confidence: 80%

See 1 more Smart Citation

Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study

Gan

Zhu

et al. 2015

J. Zhejiang Univ. Sci. B

View full text Add to dashboard Cite

Abstract:In many traditional Chinese medicine (TCM) hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality. A retrospective surveillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions. Escherichia coli (25.5%) was the most common Gram-negative and coagulase-negative staphylococcus (CoNS) (14.1%) was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsiella pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glycopeptide were the most frequently used for nBSI therapy. Only about one-third of patients (157/482) received appropriate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score >4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.

show abstract

Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 80%

Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study

Gan

Zhu

et al. 2015

J. Zhejiang Univ. Sci. B

View full text Add to dashboard Cite

show abstract

“…41 Regarding Gram-negative organisms, the EURO-BACT study found that MDR Gram-negative pathogens play a role in more than half of cases in ICU. 27 BSIs due to ESBL-producing Enterobacteriacae represent a challenge for clinicians, due to the resistance of the organisms to third generation cephalosporins. The effectiveness of antibiotic regimens including b-lactam/b-lactamase inhibitors has not been demonstrated in randomized clinical trials, in particular in the subset of critically ill patients, and carbapenems are often used as the first choice.…”

Section: Antibiotic Resistancementioning

confidence: 99%

Bloodstream infections in the Intensive Care Unit

2016

View full text Add to dashboard Cite

Bloodstream infections (BSIs) represent a common complication among critically ill patients and a leading cause of morbidity and mortality. The prompt initiation of an effective antibiotic therapy is necessary in order to reduce mortality and to improve clinical outcomes. However, the choice of the empiric antibiotic regimen is often challenging, due to the worldwide spread of multi-drug resistant (MDR) organisms with reduced susceptibility to the available broad-spectrum antimicrobials. New therapeutic strategies are 5 to improve the effectiveness of antibiotic treatment while minimizing the risk of resistance selection.

show abstract

“…However, emergence of resistance to antimicrobials is challenging our practice by threatening to reverse decades of progress [2]. Patients with few or no effective antibiotic therapy options due to resistance are increasingly observed and the possibility exists that this will worsen to the point where in some countries or patient populations the antibiotic therapy era will become only of historical relevance over the next two decades [3]. Given the current situation, antibiotic resistance, especially among Gram-negative pathogens, will most likely continue to evolve with low-income countries at greatest risk [4].…”

mentioning

confidence: 99%