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Association of Kidn...
Association of Kidney Function with Infections by Multidrug-Resistant Organisms: An Electronic Medical Record Analysis
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- Su, GB (författare)
- Karolinska Institutet
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- Xu, H (författare)
- Karolinska Institutet
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Riggi, E (författare)
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He, ZR (författare)
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Lu, LM (författare)
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- Lindholm, B (författare)
- Karolinska Institutet
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- Marrone, G (författare)
- Karolinska Institutet
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Wen, ZH (författare)
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Liu, XS (författare)
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Johnson, DW (författare)
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- Carrero, JJ (författare)
- Karolinska Institutet
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- Lundborg, CS (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2018-09-06
- 2018
- Engelska.
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 8:1, s. 13372-
- Relaterad länk:
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https://www.nature.c...
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http://kipublication...
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https://doi.org/10.1...
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Abstract
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- Antibiotic resistance is a major global health threat. High prevalences of colonization and infection with multi-drug resistance organisms (MDROs) have been reported in patients undergoing dialysis. It is unknown if this finding extends to patients with mild and moderate/severe kidney disease. An observational study included all adult incident patients hospitalized with a discharge diagnosis of infection in four hospitals from Guangzhou, China. Inclusion criteria: Serum creatinine measurement at admission together with microbial culture confirmed infections. Exclusion criterion: Undergoing renal replacement therapy. Four categories of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (eGFR) were compared: eGFR ≥ 105, 60–104 (reference), 30–59, and <30 ml/min/1.73 m2. The odds ratio of MDROs, defined as specific pathogens (Staphylococcus aureus, Enterococcus spp., Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp.) resistant to three or more antibiotic classes, were calculated using a multivariable logistic regression model across eGFR strata. Of 94,445 total microbial culture records, 7,288 first positive cultures matched to infection diagnosis were selected. Among them, 5,028 (68.9%) were potential MDROs. The odds of infections by MDROs was 19% and 41% higher in those with eGFR between 30–59 ml/min/1.73 m2 (Adjusted odds ratio, AOR): 1.19, 95% CI:1.02–1.38, P = 0.022) and eGFR < 30 ml/min/1.73 m2 (AOR: 1.41, 95% CI:1.12–1.78, P = 0.004), respectively. Patients with impaired renal function have a higher risk of infections by MDROs. Kidney dysfunction at admission may be an indicator for need of closer attention to microbial culture results requiring subsequent change of antibiotics.
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Su, GB
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Xu, H
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Riggi, E
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He, ZR
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Lu, LM
-
Lindholm, B
-
visa fler...
-
Marrone, G
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Wen, ZH
-
Liu, XS
-
Johnson, DW
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Carrero, JJ
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Lundborg, CS
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visa färre...
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Karolinska Institutet