Epidemiology and risk factors of 28-day mortality of hospital-acquired bloodstream infection in Turkish intensive care units: A prospective observational cohort study
Erişim
info:eu-repo/semantics/closedAccessTarih
2023Yazar
Aslan, Abdullah TarıkTabah, Alexis
Koylu, Bahadır
Köylü, Bahadır
Kaya Kalem, Ayşe
Aksoy, Firdevs
Erol, Çiğdem
Karaali, Rıdvan
Tunay, Burcu
Güzeldağ, Seda
Batirel, Ayşe
Dindar, Emine Kübra
Akdoğan, Özlem
Bilir, Yeliz
Akova, Murat
Üst veri
Tüm öğe kaydını gösterKünye
Aslan, A. T., Tabah, A., Koylu, B., Köylü, B., Kaya Kalem, A., Aksoy, F. ... Akova, M. (2023). Epidemiology and risk factors of 28-day mortality of hospital-acquired bloodstream infection in Turkish intensive care units: A prospective observational cohort study. The Journal of Antimicrobial Chemotherapy, 78(2), 1757-1768. https://dx.doi.org/10.1093/jac/dkad167Özet
OBJECTIVES: To uncover clinical epidemiology, microbiological characteristics and outcome determinants of hospital-acquired bloodstream infections (HA-BSIs) in Turkish ICU patients. METHODS: The EUROBACT II was a prospective observational multicontinental cohort study. We performed a subanalysis of patients from 24 Turkish ICUs included in this study. Risk factors for mortality were identified using multivariable Cox frailty models. RESULTS: Of 547 patients, 58.7% were male with a median [IQR] age of 68 [55-78]. Most frequent sources of HA-BSIs were intravascular catheter [182, (33.3%)] and lower respiratory tract [175, (32.0%)]. Among isolated pathogens (n = 599), 67.1% were Gram-negative, 21.5% Gram-positive and 11.2% due to fungi. Carbapenem resistance was present in 90.4% of Acinetobacter spp., 53.1% of Klebsiella spp. and 48.8% of Pseudomonas spp. In monobacterial Gram-negative HA-BSIs (n = 329), SOFA score (aHR 1.20, 95% CI 1.14-1.27), carbapenem resistance (aHR 2.46, 95% CI 1.58-3.84), previous myocardial infarction (aHR 1.86, 95% CI 1.12-3.08), COVID-19 admission diagnosis (aHR 2.95, 95% CI 1.25-6.95) and not achieving source control (aHR 2.02, 95% CI 1.15-3.54) were associated with mortality. However, availability of clinical pharmacists (aHR 0.23, 95% CI 0.06-0.90) and source control (aHR 0.46, 95% CI 0.28-0.77) were associated with survival. In monobacterial Gram-positive HA-BSIs (n = 93), SOFA score (aHR 1.29, 95% CI 1.17-1.43) and age (aHR 1.05, 95% CI 1.03-1.08) were associated with mortality, whereas source control (aHR 0.41, 95% CI 0.20-0.87) was associated with survival. CONCLUSIONS: Considering high antimicrobial resistance rate, importance of source control and availability of clinical pharmacists, a multifaceted management programme should be adopted in Turkish ICUs.
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Q1Kaynak
The Journal of Antimicrobial ChemotherapyCilt
78Sayı
2Koleksiyonlar
- Makale Koleksiyonu [3651]
- PubMed İndeksli Yayınlar Koleksiyonu [4050]
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