Risk Factors Associated With 30-Day Mortality Among Neonates With A. baumannii Sepsis

Thatrimontrichai, Anucha; Tonjit, Pichitra; Janjindamai, Waricha; Dissaneevate, Supaporn; Maneenil, Gunlawadee; Phatigomet, Manapat

doi:10.1097/inf.0000000000003231

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…The disease was reported more in boys in other surveys in Iran and different parts of the world (14). Although gender is considered a risk factor for infections and sepsis during the neonatal period, there is no difference between boys and girls after this period, especially for viral infections (15). About 8%of children were treated twice, and some had more than twice a diagnosis of COVID-19.…”

Section: Discussionmentioning

confidence: 92%

A longitudinal study of children with COVID-19 in outpatient centers in terms of clinical manifestations, hospitalization, antibiotic prescription, and the number of COVID-19 times

Hosseininasab

Alidousti

Jafari

et al. 2022

Preprint

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Background: A few months after the first description of COVID-19 in China, there was evidence that this serious problem was increasing worldwide. The SARS-CoV-2 virus has several subtypes with different characteristics. The disease is mild in children, and patients with this infection are generally not expected to receive antibiotics. This study aimed to focus on the number of times a person gets sick with COVID-19 and the use of antibiotics due to secondary bacterial infections in outpatient children. Methods: From February 2020 to August 2022, children aged <15 years diagnosed with SARS-CoV-2 infection were studied regarding clinical manifestations, need for hospitalization, antibiotic prescription, and the number of COVID-19 infection times. Results: Of 2448 children with the final diagnosis of COVID-19, 65% were boys, 192 people (7.84%) were infected with COVID-19 twice, 35 (1.43%) three times, 7 (0.29%) four times, and 2 (0.14%) five times, and 143 (5.84%) needed hospitalization. The prevalence of antibiotic use was 17.73% (n = 434); Acute bacterial sinusitis (12.21%) and middle ear infection (8.52%) were the most common known reasons for an antibiotic prescription, respectively. Conclusions: Several subtypes of SARS-CoV-2 have different clinical behaviors in the age group of children. A person may be infected with COVID-19 several times. The use of antibiotics in outpatients is insignificant and mostly limited to acute sinusitis and middle ear infection.

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Section: Discussionmentioning

confidence: 92%

A longitudinal study of children with COVID-19 in outpatient centers in terms of clinical manifestations, hospitalization, antibiotic prescription, and the number of COVID-19 times

Hosseininasab

Alidousti

Jafari

et al. 2022

Preprint

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“…Similarly, GNB sepsis ended fatally in 67.7% ( Acinetobacter ), 58.2% ( Klebsiella ), and 58.3% ( Pseudomonas ) of patients, with multiple antibiotic resistance as the only confirmed predictor of fatal outcome [ 37 ]. The main contributors to a fatal outcome in newborns with Acinetobacter sepsis were septic shock, with odds of 41.38, and inadequate antibiotic treatment, showing a 10-times-higher risk [ 38 ]. According to a recent systematic review, antibiotic resistance caused by insufficient empiric care is a serious concern in the rising prevalence of GNB sepsis in infants [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Mortality in Early Neonatal Sepsis: A Single-Center Experience

Jovičić¹,

Milosavljević

Folić

et al. 2023

Medicina

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Background and Objectives: Early neonatal sepsis is associated with a significant mortality rate despite modern treatment strategies. Our aim was to identify risk factors contributing to the occurrence of death in newborns with early neonatal sepsis. Materials and Methods: We conducted a retrospective cross-sectional study that included newborns with early sepsis who received care in the intensive and semi-intensive care units at the Institute of Neonatology, Belgrade, Serbia. Newborns with early neonatal sepsis who died comprised the case group, whereas those who survived made up the control group. The diagnostic and therapeutic approach to the septic condition was carried out independently of this study, according to valid hospital protocols and current good practice guidelines. The influence of a large number of variables on the examined dichotomous outcome, as well as the mutual interaction of potential predictor variables, was examined by binary logistic regression. Results: The study included 133 pregnant women and 136 newborns with early neonatal sepsis, of which 51 (37.5%) died, while the remaining 85 newborns (62.5%) survived. Newborns who died had a statistically significantly lower birth weight compared to those who survived (882.8 ± 372.2 g vs. 1660.9 ± 721.1 g, p = 0.000). Additionally, compared to newborns who survived, among the deceased neonates there was a significantly higher proportion of extremely preterm newborns (74.5% vs. 22.4%, p = 0.000). The following risk factors for the occurrence of death in early neonatal sepsis were identified: low birth weight, sepsis caused by gram-negative bacteria, and the use of double-inotropic therapy and erythrocyte transfusion during the first week. Conclusions: Pediatricians should pay special attention to infants with early neonatal sepsis in whom any of the identified risk factors are present in order to prevent a fatal outcome.

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“…Surprisingly, after analysing the use of antibiotics before a positive blood culture was observed, we found that when there was no significant difference in the TBSA and the third-degree burn are between the two groups of patients, whether the antibiotics that were used were appropriate had no effect on the length of hospital stay, the length of ICU stay, or in-hospital mortality. However, it has previously been reported that whether or not the initial antibiotic used for in patients with infection is appropriate is not associated with mortality 36,37 and that the use of inappropriate initial antibiotics in infected patients leads to an increase in mortality 25,38 www.nature.com/scientificreports/ Such contradictory results may be explained as follows: 1. In addition to the selection of appropriate antibiotics, whether anti-infective treatment is effective is also related to the specific bacterial resistance and the method of antibiotic administration 25 .…”

Section: Discussionmentioning

confidence: 99%

Characteristics of bloodstream infection and initial antibiotic use in critically ill burn patients and their impact on patient prognosis

Yin

Bei-wen

Zhenzhu

et al. 2022

Sci Rep

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To investigate the bacterial epidemiology of blood cultures taken during the treatment of critically ill burn patients, the use of antibiotics at admission and before the observation of positive blood cultures, and their effect on prognosis. A retrospective study method was used. From January 1, 2010, to December 31, 2019, burn patients who met the inclusion criteria and were treated at the Burn Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, were enrolled in the study. Data were collected from the patients’ electronic medical records. General patient information, including length of hospital stay, length of intensive care unit (ICU) stay, in-hospital mortality, the bacteria epidemiological characteristics of blood cultures, and the use of antibiotics within 24 h after admission and before a positive blood culture was observed, was collected. Independent sample t tests and χ2 tests were used to compare the effects of a positive blood culture and the use of appropriate antibiotics within 24 h after admission and before the observation of a positive blood culture on prognosis. (1) The three most frequently detected bacteria in the blood cultures were Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, and the amount of K. pneumoniae detected increased gradually. (2) Compared with the group of patients who were negative for bloodstream infection , the positive bloodstream infection group had a larger total body burn surface area (TBSA) (t = − 5.097, P = 0.000) and third-degree burn area (t = − 5.133, P = 0.000), a significantly longer length of hospital stay (t = 3.003, P = 0.003) and the length of ICU stay (t = 4.258, P = 0.000), and a significantly higher rate of in-hospital mortality (χ2 = 8.485, P = 0.004). When K. pneumoniae was detected, the length of hospital stay (t = 2.148, P = 0.035) and the length of ICU stay (t = 2.880, P = 0.005) were significantly prolonged. (3) The two antibiotics that were most frequently used in patients with acute burns within 24 h after admission were lincomycin (90 cases, 29.32%) and carbapenems (79 cases, 25.73%). Comparing the clinical characteristics of the lincomycin group and the carbapenem group, the TBSA (t = − 3.34, P = 0.001) and the third-degree burn area (t = − 6.08, P = 0.000) of the patients in the carbapenem group were larger, and the length of hospital stay (t = − 2.136, P = 0.035) and length of ICU stay (t = − 5.18, P = 0.000) were longer, but the difference in in-hospital mortality was not statistically significant (χ2 = 1.983, P = 0.159). (4) Comparing the group with appropriate initial antibiotic use within 24 h of admission to the inappropriate use group, the TBSA (t = − 0.605, P = 0.547), the third-degree burn area (t = 0.348, P = 0.729), the length of hospital stay (t = − 0.767, P = 0.445), the length of ICU stay (t = − 0.220, P = 0.827) and in-hospital mortality (χ2 = 1.271, P = 0.260) were not significantly different. (5) Comparing the group with appropriate antibiotic use before a positive blood culture was observed to the group with inappropriate antibiotic use, the TBSA (t = − 0.418, P = 0.677), the third-degree burn area (t = 0.266, P = 0.791), the length of hospital stay, the length of ICU stay (t = 0.995, P = 0.322) and in-hospital mortality (χ2 = 1.274, P = 0.259) were not significantly different. We found that patients with a positive blood culture had a larger burn area and a worse prognosis; that the greater the amount of K. pneumoniae in the bloodstream of burn patients was, the longer the hospital and ICU stays were; that whether appropriate antibiotics were administered to acute critical burn patients 24 h after admission had no effect on the prognosis; and that whether appropriate antibiotics were administered before a positive blood culture was observed had no effect on prognosis.

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Risk Factors Associated With 30-Day Mortality Among Neonates With A. baumannii Sepsis

Cited by 9 publications

References 26 publications

A longitudinal study of children with COVID-19 in outpatient centers in terms of clinical manifestations, hospitalization, antibiotic prescription, and the number of COVID-19 times

A longitudinal study of children with COVID-19 in outpatient centers in terms of clinical manifestations, hospitalization, antibiotic prescription, and the number of COVID-19 times

Predictors of Mortality in Early Neonatal Sepsis: A Single-Center Experience

Characteristics of bloodstream infection and initial antibiotic use in critically ill burn patients and their impact on patient prognosis

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