Registry-Based Retrospective Cohort Study of Mortality among Adults Admitted to Intensive Care Units in Istanbul with Hospital Acquired Pseudomonas aeruginosa Bloodstream-Infection between 2014–2021
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Published:2024-01-17
Issue:1
Volume:13
Page:90
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ISSN:2079-6382
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Container-title:Antibiotics
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language:en
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Short-container-title:Antibiotics
Author:
Derin Okan12ORCID, Şahin Meyha3ORCID, Dumlu Rıdvan4, Başgönül Sedef5, Bayrak Ahmet Doğukan26ORCID, Arduç Şevval67ORCID, Bayram Sümeyye46, Mikaliyova Nurlana3, Kantürk Arzu4, Öncül Ahsen2, Yıldız Sevgi Dilek26ORCID, Gençer Serap5ORCID, Bayraktar Banu67, Dökmetaş İlyas26, Mert Ali8
Affiliation:
1. Graduate School of Health Sciences, Epidemiology Doctorate Program, Istanbul Medipol University, 34815 Istanbul, Turkey 2. Istanbul Şişli Hamidiye Etfal Training and Research Hospital Infectious Diseases and Clinical Microbiology, 34396 Istanbul, Turkey 3. Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, 34214 Istanbul, Turkey 4. Istanbul Prof. Dr. Cemil Taşçıoğlu Training and Research Hospital, Infectious Diseases and Clinical Microbiology, 34384 Istanbul, Turkey 5. Department of Infectious Diseases and Clinical Microbiology, Acıbadem Mehmet Ali Aydınlar University, 34752 Istanbul, Turkey 6. Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668 Istanbul, Turkey 7. Istanbul Şişli Hamidiye Etfal Training and Research Hospital Microbiology and Clinical Microbiology, 34396 Istanbul, Turkey 8. Department of Internal Medicine, Istanbul Medipol University, 34815 Istanbul, Turkey
Abstract
Background: Managing Pseudomonas aeruginosa bloodstream infections (BSIs) is challenging due to increasing antimicrobial resistance, limited therapeutic options, and high mortality rates. In this study, we aimed to identify 30-day mortality risk factors and assess infectious diseases consultants’ preferences for combination or monotherapy. Methods: The study was conducted in four hospitals in Istanbul, Turkey, involving 140 adult ICU beds and 336,780 ICU-bed-days between 1 January 2014, and 31 December 2021. A total of 157 patients were included in the study. Cox proportional hazard regression was performed to assess the factors on 30-day mortality. Results: The 30-day mortality rate was 44.6% (70/157). Higher Charlson Comorbidity Index (CCI) score, severe sepsis, primary bloodstream infection, being in COVID-19 pandemic period, and infection caused by MDR strain were associated with higher hazard of 30-day mortality. Combination therapy was more commonly used in patients with BSIs with MDR or DTR (difficult-to-treat) strains but did not significantly improve the hazard of 30-day mortality. Conclusions: Targeted interventions and vigilant management strategies are crucial for patients with defined risk factors. While infectious disease consultants tended to favor combination therapy, particularly for drug-resistant strains, our analysis revealed no significant impact on 30-day mortality hazard. The increased incidence of P. aeruginosa BSIs during the pandemic emphasizes the need for infection control measures and appropriate antibiotic prescribing practices.
Subject
Pharmacology (medical),Infectious Diseases,Microbiology (medical),General Pharmacology, Toxicology and Pharmaceutics,Biochemistry,Microbiology
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