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Treatment pattern, ...
Treatment pattern, prognostic factors, and outcome in patients with infection due to pan-drug-resistant gram-negative bacteria
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- Kofteridis, Diamantis P. (författare)
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
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- Andrianaki, Angeliki M. (författare)
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
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- Maraki, Sofia (författare)
- Department of Clinical Microbiology, University Hospital of Heraklion, Heraklion, Crete, Greece
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- Mathioudaki, Anna (författare)
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
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- Plataki, Marina (författare)
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
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- Alexopoulou, Christina (författare)
- Department of Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece
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- Ioannou, Petros (författare)
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
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- Samonis, George (författare)
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
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- Valachis, Antonis, 1984- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Oncology
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(creator_code:org_t)
- 2020-01-13
- 2020
- Engelska.
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Ingår i: European Journal of Clinical Microbiology and Infectious Diseases. - : Springer. - 0934-9723 .- 1435-4373. ; 39:5, s. 965-970
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- The present study investigated the clinical course, treatment pattern, prognostic factors, and outcome of patients with pun-drug resistant (PDR) infections. This was a retrospective single-center cohort study including consecutive eligible patients with a PDR infection hospitalized at the University Hospital of Heraklion, Crete, Greece, between January 2010 and June 2018. In total, 65 patients with infections due to PDR gram-negative pathogens were identified. The median age was 64 years (interquartile range, IQR: 45.5-74.5) and the median Charlson comorbidity index 3.0 (IQR: 1.0-5.75). Of the 65 PDR isolates, 31 (48%) were Klebsiella pneumoniae, 28 (43%) Acinetobacter baumannii, and 6 (9%) Pseudomonas aeruginosa. The most common empirical therapy was colistin-based combination (n = 32; 49%), followed by non-colistin, non-tigecycline combination (n = 25; 39%), and carbapenemes + tigecycline (n = 8; 12%). The empirical therapy was effective in 50%, 37.5%, and 8% of patients receiving colistin combination, carbapenemes - tigecycline, and non-colistin, non-tigecycline combination, respectively (p value = 0.003). The infection-related in-hospital mortality was 32% (95% confidence interval, CI: 21-45%). Three factors were significantly associated with infection-related in-hospital mortality in multivariate analysis: Charlson comorbidity index (odds ratio, OR: 1.5, 95% CI: 1.0-2.3, p value = 0.030), prior steroid use (OR: 4.1, 95% CI: 1.0-17.0, p value = 0.049), and empirical treatment with non-colistin, non-tigecycline combination (OR: 7.5; 95% CI: 1.7-32.8, p value = 0.008). Infections due to PDR pathogens are associated with considerable mortality. Our results support the use of colistin and/or tigecycline-based combinations as empirical therapy when infection due to PDR pathogens is suspected.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Nyckelord
- Acinetobacter baumannii
- Colistin
- Klebsiella pneumonia
- Pan-drug-resistant bacteria
- Pseudomonas aeruginosa
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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