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.Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece (author)

Treatment pattern, prognostic factors, and outcome in patients with infection due to pan-drug-resistant gram-negative bacteria

Article/chapterEnglish2020

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2020-01-13
Springer,2020
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LIBRIS-ID:oai:DiVA.org:oru-79786
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-79786URI
https://doi.org/10.1007/s10096-019-03784-9DOI

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Language:English
Summary in:English

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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.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Infektionsmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Infectious Medicine hsv//eng
Acinetobacter baumannii
Colistin
Klebsiella pneumonia
Pan-drug-resistant bacteria
Pseudomonas aeruginosa

Added entries (persons, corporate bodies, meetings, titles ...)

Andrianaki, Angeliki M.Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece (author)
Maraki, SofiaDepartment of Clinical Microbiology, University Hospital of Heraklion, Heraklion, Crete, Greece (author)
Mathioudaki, AnnaDepartment of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece (author)
Plataki, MarinaDepartment of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece (author)
Alexopoulou, ChristinaDepartment of Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece (author)
Ioannou, PetrosDepartment of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece (author)
Samonis, GeorgeDepartment of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece (author)
Valachis, Antonis,1984-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Oncology(Swepub:oru)asvs (author)
Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, GreeceDepartment of Clinical Microbiology, University Hospital of Heraklion, Heraklion, Crete, Greece (creator_code:org_t)

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In:European Journal of Clinical Microbiology and Infectious Diseases: Springer39:5, s. 965-9700934-97231435-4373

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