Clinical characteristics and risk factors of polymicrobial Staphylococcus aureus bloodstream infections

Zheng, Cheng; Zhang, Shufang; Chen, Qingqing; Zhong, Li; Huang, Tongwang; Zhang, Xijiang; Zhang, Kai; Zhou, Hongwei; Cai, Jiachang; Du, Linlin; Wang, Changming; Cui, Wei; Zhang, Gensheng

doi:10.1186/s13756-020-00741-6

Cited by 21 publications

(29 citation statements)

References 35 publications

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“…Consistent with our findings, a longer length of hospital stay was also observed in patients with carbapenem-resistant KP-BSI than those with carbapenem-susceptible KP-BSI in Tian et al's study [12]. Nevertheless, differences in mortality were not significant either in our study or in other studies for polymicrobial BSI of other pathogens such as Candida, Enterococcus, Staphylococcus aureus, or A. baumannii [31,[37][38][39]. Kohler et al's meta-analysis indicated that appropriateness of empirical antimicrobial therapy was an important contributor to the observed difference in mortality between patients with carbapenem-resistant KP-BSI and patients with carbapenem-susceptible KP-BSI [40].…”

Section: Discussionsupporting

confidence: 91%

Clinical Characteristics, Risk Factors, and Outcomes of Patients with Polymicrobial Klebsiella pneumoniae Bloodstream Infections

Song

Zhang

Huang

et al. 2021

BioMed Research International

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Background. Polymicrobial Klebsiella pneumoniae bloodstream infection (KP-BSI) has been reported to account for more than 10% of all KP-BSI, but few studies have characterized polymicrobial KP-BSI. Our study investigated the clinical characteristics, risk factors, and outcomes of polymicrobial KP-BSI by comparing with monomicrobial KP-BSI. Methods. We conducted a single-center retrospective cohort study of patients with KP-BSI from 1 January 2013 to 31 December 2018 and collected the clinical data by reviewing electronic medical records. Results. Of the 818 patients with KP-BSI recruited, 13.9% (114/818) were polymicrobial KP-BSI. The severity of illness in polymicrobial and monomicrobial KP-BSI was similar, while the rate of resistance to carbapenems was obviously higher in polymicrobial KP-BSI (78.1% vs. 65.6%, p = 0.009 ). On multivariate analysis, hospitalization in burn ward (odds ratio (OR) 6.13, 95% confidence interval (CI) 2.00-18.76, p = 0.001 ) and intensive care unit (OR 2.39, 95% CI 1.05-5.43, p = 0.038 ) was independently associated with polymicrobial KP-BSI. Gram-negative bacteria accounted for the highest proportion (68.9%) among copathogens of polymicrobial KP-BSI, whereas gram-positive bacteria (22.9%) and Candida (8.2%) ranked the second and the third, respectively, with Acinetobacter baumannii being the most common (23.0%). Patients with polymicrobial KP-BSI had longer hospital days after BSI onset and total hospital days than patients with monomicrobial KP-BSI (median (interquartile range (IQR)), 19 (5, 39) vs. 12 (6, 25), 37 (21, 67) vs. 29 (16, 53), respectively, p < 0.05 ). The mortality did not differ between polymicrobial KP-BSI and monomicrobial KP-BSI (all p > 0.05 ). Conclusions. It was observed that polymicrobial KP-BSI accounted for a significant proportion among all KP-BSI in the current study. Hospitalization in burn ward and intensive care unit was an independent risk factor for the development of polymicrobial KP-BSI. The patients with polymicrobial KP-BSI had a higher rate of carbapenem-resistant K. pneumoniae and might have poor outcomes compared to monomicrobial KP-BSI.

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Section: Discussionsupporting

confidence: 91%

Clinical Characteristics, Risk Factors, and Outcomes of Patients with Polymicrobial Klebsiella pneumoniae Bloodstream Infections

Song

Zhang

Huang

et al. 2021

BioMed Research International

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“…Once it happened, invasive devices such as ventilator and central venous catheterization were required. These were the major risk factors of secondary infections con rmed in many previous studies [26][27][28][29][30].…”

Section: Discussionsupporting

confidence: 64%

Risk Factors of Secondary Infections in Severe and Critical Patients Hospitalized with COVID-19: A Case-Control Study

Cao

Cai

et al. 2020

Preprint

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Background: Severe patients hospitalized with COVID-19 suffered secondary infections which greatly increased the length of hospital stay and the mortality. We aimed to explore risk factors of secondary infections that can help clinicians early implement preventive measures to dispose of severe and critical inpatients with COVID-19.Methods: A case-control study enrolled 238 severe and critical patients with COVID-19. Characteristics of cases and controls were compared.Results: Severity of illness on admission, ICU admission, ventilator, central venous catheterization were common in the cases, however almost none of these factors was observed in the controls. Multivariable regression showed risk factors of secondary infections included male (OR 4.08; 95% CI 1.58-10.50), age 65 or older (OR 3.11; 95% CI 1.25-7.76), heart diseases (OR 3.96; 95% CI 1.40-11.27), hypoproteinemia on admission (OR 6.41; 95% CI 1.65-24.92) and corticosteroids (OR 19.83; 95% CI 7.3-53.55) and proton-pump inhibitors (OR 3.96; 95% CI 1.51-10.37).Conclusions: male, older age, heart diseases, hypoproteinemia, corticosteroid and proton-pump inhibitors were independent risk factors of secondary infections. Inpatients needing ICU admission and invasive devices still need to be given optimal cares and to be minimized the duration.

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“…The definition of MRD was based on the international expert proposal for interim standard [ 20 ]. Polymicrobial infection referred to ≥2 causative organisms isolated from a single blood culture [ 21 ]. Empirical antibiotic treatment was regarded as being “appropriate” if the isolated causative organisms were susceptible to ≥1 of the antimicrobial agents administered in vitro.…”

Section: Methodsmentioning

confidence: 99%

Epidemiology, risk factors and outcomes of bloodstream infection caused by ESKAPEEc pathogens among hospitalized children

et al. 2021

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Background Bloodstream infection (BSI) resulting from ESKAPEEc pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp) is relevant to high mortality and economic cost. Data concerning the impact of BSI due to ESKAPEEc in pediatric population was virtually scant. Our purpose was to summarize the epidemiology, risk factors and outcomes of ESKAPEEc BSI among hospitalized children. Methods Inpatients diagnosed with BSI with definite etiology between January 2016 and December 2018 were enrolled retrospectively at the West China Second University Hospital. Data were systematically reviewed on patients’ clinical characteristics and laboratory findings to ascertain independent predictors, clinical features and outcomes. Results Of the 228 patients with BSI, 174 (76.3%) were caused by ESKAPEEc (124 MDR-ESKAPEEc). Multivariate analysis demonstrated that premature and/ or low birth weight (odds ratio [OR] = 2.981, P = 0.036), previous surgery and/or trauma (OR = 5.71, P = 0.029) and source of urinary tract infection (OR = 10.60, P = 0.004) were independently associated with ESKAPEEc BSI. The independent risk factor for MRD-ESKAPEEc BSI was nosocomial infection (OR = 3.314, P = 0.037). The overall mortality rate in patients with ESKAPEEc BSI was 14.4% (25/174), and no significant difference was ascertained in mortality between MRD-ESKAPEEc and non-MRD ESKAPEEc BSI groups (13.7% vs. 11.4%, P = 0.692). In addition, previous surgery and/or trauma, thrombocytopenia, and mechanical ventilation were significant risk factors for mortality caused by ESKAPEEc BSI. Conclusions More than two-thirds of BSI among hospitalized children were caused by ESKAPEEc. Previous surgery and/or trauma, thrombocytopenia and mechanical ventilation increased the risk rate for mortality in ESKAPEEc BSI. The risk factors ascertained could assist physicians to early suspect ESKAPEEc BSI and MDR ESKAPEEc BSI.

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Clinical characteristics and risk factors of polymicrobial Staphylococcus aureus bloodstream infections

Cited by 21 publications

References 35 publications

Clinical Characteristics, Risk Factors, and Outcomes of Patients with Polymicrobial Klebsiella pneumoniae Bloodstream Infections

Clinical Characteristics, Risk Factors, and Outcomes of Patients with Polymicrobial Klebsiella pneumoniae Bloodstream Infections

Risk Factors of Secondary Infections in Severe and Critical Patients Hospitalized with COVID-19: A Case-Control Study

Epidemiology, risk factors and outcomes of bloodstream infection caused by ESKAPEEc pathogens among hospitalized children

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