Increased financial burdens and lengths of stay in patients with healthcare-associated infections due to multidrug-resistant bacteria in intensive care units: A propensity-matched case-control study

Su, Li-Hsiang; Chen, I‐Ling; Tang, Ya-Fen; Lee, Jen-Sin; Liu, Jien-Wei

doi:10.1371/journal.pone.0233265

Cited by 21 publications

(12 citation statements)

References 38 publications

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“…We obtained: (1) socio-demographic data including age, sex, body weight, height and body mass index; (2) underlying infection, antibiotic treatment within ten days before tigecycline initiation and pathogens resistance; (3) date and time of first tigecycline application, duration of treatment and the date of therapy termination; (4) amount of tigecycline daily dosage (mg/d), total received amount of tigecycline and potential change of standard dosage; (5) coagulation status including platelets count (g/L), fibrinogen Clauss (mg/dL), prothrombin time (PT, %), activated partial thromboplastin time (aPTT, seconds) and antithrombin (%); (6) other laboratory parameters as hemoglobin (g/L), hematocrit (L/L), erythrocytes (T/L), white blood cells (WBC, g/L), protein (g/dL), C-reactive protein (CRP, mg/dL), creatinine (mg/dL), bilirubin (mg/dL), serum glutamic oxaloacetic transaminase (u/L) and serum glutamic pyruvic transaminase (u/L); and finally (7), data on ICU mortality and in-hospital mortality.…”

Section: Data Collectionmentioning

confidence: 99%

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Progression of Fibrinogen Decrease during High Dose Tigecycline Therapy in Critically Ill Patients: A Retrospective Analysis

Treml

Bukumirić

Hell

et al. 2021

JCM

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Tigecycline is a novel glycylcycline broad-spectrum antibiotic offering good coverage for critically ill patients experiencing complicated infections. A known side effect is a coagulation disorder with distinct hypofibrinogenemia. To date, the information on possible risk factors and outcomes is sparse. Therefore, the aim of this study is to examine the time course of fibrinogen level changes during tigecycline therapy in critically ill patients. Moreover, we sought to identify risk factors for coagulopathy and to report on clinically important outcomes. We retrospectively reviewed all intensive care patients admitted to our General and Surgical Intensive Care Unit receiving tigecycline between 2010 and 2018. A total of 130 patients were stratified into two groups based on the extent of fibrinogen decrease. Patients with a greater fibrinogen decrease received a higher dose, a longer treatment and more dose changes of tigecycline, respectively. In regard to the underlying pathology, these patients showed higher inflammation markers as well as a slightly reduced liver synthesis capacity. We, therefore, conclude that such a fibrinogen decrease may be based upon further impairment of liver synthesis during severe inflammatory states. To decrease the risk of bleeding, cautious monitoring of coagulation in critically ill patients treated with high-dose tigecycline is warranted.

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Section: Data Collectionmentioning

confidence: 99%

“…Critically ill patients often suffer from complicated medical or surgical conditions, exposing them to the development of multi-drug-resistant infections, leading to longer hospital stays, higher mortality and increased costs [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Progression of Fibrinogen Decrease during High Dose Tigecycline Therapy in Critically Ill Patients: A Retrospective Analysis

Treml

Bukumirić

Hell

et al. 2021

JCM

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“…Some differences in the hospital unit's colonization profile can be related to patient's turnover and hospital stay in each unit, as well as the severity illness of inpatients. As seen in the HAI risk factor analysis, longer hospital stay is correlated with the presence of HAI in the current hospitalization, specific HAIrB increase and invasive device use, with several large studies also documenting these correlations (Jia et al, 2019;Sahiledengle et al, 2020;Su et al, 2020). EMG with high patient's turnover (shorter hospital stay), showed less HAIrB load compared to the total bacteria, as well as lower positivity of BL genes, MDR and CARB-R bacteria.…”

Section: Discussionmentioning

confidence: 82%

Healthcare-Associated Infections-Related Bacteriome and Antimicrobial Resistance Profiling: Assessing Contamination Hotspots in a Developing Country Public Hospital

Sereia

Christoff²,

Cruz³

et al. 2021

Front. Microbiol.

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Hospital-built environment colonization by healthcare-associated infections-related bacteria (HAIrB) and the interaction with their occupants have been studied to support more effective tools for HAI control. To investigate HAIrB dynamics and antimicrobial resistance (AMR) profile we carried out a 6-month surveillance program in a developing country public hospital, targeting patients, hospital environment, and healthcare workers, using culture-dependent and culture-independent 16S rRNA gene sequencing methods. The bacterial abundance in both approaches shows that the HAIrB group has important representativeness, with the taxa Enterobacteriaceae, Pseudomonas, Staphylococcus, E. coli, and A. baumannii widely dispersed and abundant over the time at the five different hospital units included in the survey. We observed a high abundance of HAIrB in the patient rectum, hands, and nasal sites. In the healthcare workers, the HAIrB distribution was similar for the hands, protective clothing, and mobile phones. In the hospital environment, the healthcare workers resting areas, bathrooms, and bed equipment presented a wide distribution of HAIrB and AMR, being classified as contamination hotspots. AMR is highest in patients, followed by the environment and healthcare workers. The most frequently detected beta-lactamases genes were, blaSHV–like, blaOXA–23–like, blaOXA–51–like, blaKPC–like, blaCTX–M–1, blaCTX–M–8, and blaCTX–M–9 groups. Our results demonstrate that there is a wide spread of antimicrobial resistance due to HAIrB in the hospital environment, circulating among patients and healthcare workers. The contamination hotspots identified proved to be constant over time. In the fight for patient safety, these findings can reorient practices and help to set up new guidelines for HAI control.

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“…In the era of increasing prevalence of MDR bacterial infections, MDR GNB is strongly associated with mortality in critically ill surgical patients [22]. Our study investigated the independent risk factors associated with MDR GNB infection after abdominal surgery and highlights MDR GNB infection is associated with a lower 30-day survival compared to non-MDR GNB infection.…”

Section: Discussionmentioning

confidence: 89%

Risk Factors and Outcomes for Multidrug-resistant Gram-negative Bacterial Infection in Adult Patients with Abdominal Surgery Requiring Intensive Care

Lin¹,

Chang²,

Chen³

et al. 2021

Preprint

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Background: Multidrug-resistant (MDR) gram-negative bacterial (GNB) infections remain a significant cause of morbidity and mortality among surgical patients. The objective of our study was to recognize the risk factors for MDR GNB infection in surgical intensive care unit (SICU) patients with abdominal surgery and determine the predictors independently associated with death.Methods: From 2010 to 2017, a retrospective cohort study was conducted among patients with abdominal surgery admitted in SICU. Patients with GNB (MDR and non-MDR) infections were included for analyses. Results: A total of 364 patients with abdominal surgery experienced GNB infections, among them, 117 (32.1%) were MDR GNB infections. Of 133 MDR GNB isolates, the most frequent isolate was Escherichia coli (45.1%). Patients with MDR GNB infection had significantly longer ventilator days and hospital stay, as well as higher 30-day and in-hospital mortality compared to non-MDR GNB patients. Multivariable analysis showed longer length of pre-ICU stay, surgical re-exploration, received anti-pseudo carbapenems and fluoroquinolones, and higher total bilirubin were independent risk factors for the acquisition of MDR GNB infection. Predictors for 30-day mortality among patients with MDR GNB infection were chronic kidney disease, received anti-pseudo carbapenems and inappropriate empirical antimicrobial therapy.Conclusions: This study provides important information about the risk factors for subsequent MDR GNB infection and 30-day mortality among the patients with abdominal surgery. Given the increasingly MDR GNB infection and mortality, implementation of antimicrobial stewardship programs in critical care unit is crucial to reduce MDR pathogens and optimize antimicrobial therapies.

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Increased financial burdens and lengths of stay in patients with healthcare-associated infections due to multidrug-resistant bacteria in intensive care units: A propensity-matched case-control study

Cited by 21 publications

References 38 publications

Progression of Fibrinogen Decrease during High Dose Tigecycline Therapy in Critically Ill Patients: A Retrospective Analysis

Progression of Fibrinogen Decrease during High Dose Tigecycline Therapy in Critically Ill Patients: A Retrospective Analysis

Healthcare-Associated Infections-Related Bacteriome and Antimicrobial Resistance Profiling: Assessing Contamination Hotspots in a Developing Country Public Hospital

Risk Factors and Outcomes for Multidrug-resistant Gram-negative Bacterial Infection in Adult Patients with Abdominal Surgery Requiring Intensive Care

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