Registry-Based Retrospective Cohort Study of Mortality among Adults Admitted to Intensive Care Units in Istanbul with Hospital Acquired Pseudomonas aeruginosa Bloodstream-Infection between 2014–2021

Derin, Okan; Şahin, Meyha; Dumlu, Rıdvan; Başgönül, Sedef; Bayrak, Ahmet Doğukan; Arduç, Şevval; Bayram, Sümeyye; Mikaliyova, Nurlana; Kantürk, Arzu; Öncül, Ahsen; Yıldız Sevgi, Dilek; Gençer, Serap; Bayraktar, Banu; Dökmetaş, İlyas; Mert, Ali

doi:10.3390/antibiotics13010090

Cited by 3 publications

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Multiple Organ Scoring Systems for Predicting In-Hospital Mortality of Sepsis Patients in the Intensive Care Unit

Zhou,

Zhang,

Wang

et al. 2024

Preprint

View full text Add to dashboard Cite

Objective This study aims to comprehensively evaluate the Charlson Comorbidity Index (CCI), Logistic Organ Dysfunction System (LODS) score, Acute Physiology Score III (APS III), Simplified Acute Physiology Score II (SAPS II), and SOFA (Sequential Organ Failure Assessment) in order to provide a more scientifically rigorous and effective tool for predicting mortality risk among sepsis patients in the Intensive Care Unit (ICU). Methods The demographic information and sepsis-related data were extracted from the MIMIC-IV database for patients admitted to the ICU with a diagnosis of sepsis. The predictive performance of CCI, LODS, APS III, SAPS II, and SOFA scoring systems in terms of ICU mortality was evaluated by comparing receiver operating characteristic (ROC) curves. Furthermore, multivariate regression analysis was conducted to identify potential predictors which were subsequently validated using a nomogram. Finally, the dataset was divided into a training set and validation set at a ratio of 7:3 to assess the clinical utility of the prediction model through ROC curves. Results The study enrolled a total of 17,226 patients with a median age of 67.65 (55.79, 78.82) years; among them, males accounted for 57.69%. Within this cohort, a total of 1,115 (6.47%) individuals succumbed during their admission to the ICU. The ROC curve demonstrated that both APS III and LODS score exhibited robust predictive value for ICU mortality. Multivariate regression analysis revealed that CCI, APS III score, LODS score, respiratory rate, body temperature, and race served as potential predictors. The integration of these indicators into a nomogram demonstrated significant clinical relevance, as evidenced by an area under the curve (AUC) of 0.803 in the training set and 0.797 in the validation set. Conclusions Organ failure scores hold significant clinical relevance in predicting mortality among sepsis patients in the ICU. Augmenting predictive accuracy can be achieved by integrating the CCI, APS III score, LODS score, mean respiratory rate, and body temperature during the initial 24 hours following ICU admission.

show abstract

Multiple Organ Scoring Systems for Predicting In-Hospital Mortality of Sepsis Patients in the Intensive Care Unit

Zhou,

Zhang,

Wang

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Bloodstream Infections Due to Wild-Type Pseudomonas aeruginosa: Carbapenems and Ceftazidime/Avibactam Prescription Rate and Impact on Outcomes

Pallotto,

Tommasi,

Svizzeretto

et al. 2024

Infectious Disease Reports

View full text Add to dashboard Cite

Background. Pseudomonas aeruginosa is one of the major concerns among bacterial diseases even when it shows a wild-type susceptibility pattern. In 2020, EUCAST reconsidered antibiogram interpretation shifting “I” from “intermediate” to “sensible, increased exposure” with possible significant impact on antibiotic prescription. The aim of this study was to evaluate mortality in patients with P. aeruginosa bloodstream infections treated with antipseudomonal penicillins or cephalosporins vs. carbapenems and ceftazidime/avibactam. Methods. This is a retrospective observational study. All the patients with a bloodstream infection due to P. aeruginosa admitted to our hospital were enrolled. Exclusion criteria were as follows: extremely critical conditions, age <18 years, pregnancy, isolation of a strain non-susceptible to piperacillin/tazobactam and antipseudomonal cephalosporins. Patients were divided into group A (treatment with carbapenems or ceftazidime/tazobactam) and group B (treatment with antipseudomonal penicillin or cephalosporins). Results. We enrolled 77 patients, 56 and 21 in groups A and B, respectively. The two groups were homogeneous for age, sex, and biochemical and clinical characteristics at admission. All-cause in-hospital mortality was 17/56 (30.4%) and 3/21 (14.3%) in groups A and B, respectively (p > 0.1). In group A, in-hospital BSI-related mortality was 23.2% (13/56), while it was 14.3% (3/21) in group B (p > 0.1). After multivariate analysis, only the PITT score represented a risk factor for BSI-related mortality (OR 2.917, 95% CI 1.381–6.163). Conclusions. Both all-cause and BSI-related mortality were comparable between the two groups. Treatment with carbapenem or ceftazidime/avibactam did not represent a protective factor for mortality in wild-type P. aeruginosa BSI.

show abstract

Risk Factors and Outcomes of Patients with Pseudomonas aeruginosa Bloodstream Infection in the Intensive Care Unit

Caydasi,

Arslan,

Cetin

et al. 2024

Jundishapur J Microbiol

View full text Add to dashboard Cite

Background: Bloodstream infections (BSIs) caused by Pseudomonas aeruginosa have high mortality rates and pose a significant threat to healthcare settings. Objectives: We aimed to investigate the clinical risk factors related to mortality and the development of P. aeruginosa with difficult-to-treat resistance (DTR-PA) BSI in the intensive care unit. Methods: This was a retrospective, single-center study that included patients with P. aeruginosa BSI who were hospitalized between 2020 and 2022. The risk factors affecting 30-day mortality and the development of DTR-PA were investigated using both univariate and multivariate analyses. Results: A total of 140 patients were analyzed. The mean age was (66 ± 17.5) years, and 48% of the patients were male. Previous meropenem use was an independent risk factor for DTR-PA BSI (odds ratio, 2.68; 95% CI, 1.24 to 5.80; P = 0.012). Multivariate analysis demonstrated that the requirement for inotropic support was an independent risk factor for 30-day mortality [hazard ratio, 2.50; 95% confidence interval (CI), 1.33 to 4.68; P = 0.004]. Conclusions: Prior meropenem use was an independent risk factor for DTR-PA development. Strict policies for Carbapenem use and infection control procedures are essential to combat infections caused by DTR-PA.

show abstract

Registry-Based Retrospective Cohort Study of Mortality among Adults Admitted to Intensive Care Units in Istanbul with Hospital Acquired Pseudomonas aeruginosa Bloodstream-Infection between 2014–2021

Cited by 3 publications

References 37 publications

Multiple Organ Scoring Systems for Predicting In-Hospital Mortality of Sepsis Patients in the Intensive Care Unit

Multiple Organ Scoring Systems for Predicting In-Hospital Mortality of Sepsis Patients in the Intensive Care Unit

Bloodstream Infections Due to Wild-Type Pseudomonas aeruginosa: Carbapenems and Ceftazidime/Avibactam Prescription Rate and Impact on Outcomes

Risk Factors and Outcomes of Patients with Pseudomonas aeruginosa Bloodstream Infection in the Intensive Care Unit

Contact Info

Product

Resources

About