Predictive factors of in-hospital mortality in patients with laboratory-confirmed Escherichia coli, Klebsiella species or Pseudomonas aeruginosa bloodstream infections

Author:

Mitchell EleanorORCID,Pearce Mark,Roberts AnthonyORCID,Newton Julia

Abstract

Gram-negative bloodstream infections (GNBSI) are confirmed by the presence of gram-negative bacteria in the bloodstream and pose a significant healthcare issue as they increase the risk of sepsis and mortality. In England, the aim is to reduce GNBSI cases and further deterioration through enhanced population surveillance of patients with a laboratory-confirmed GNBSI to inform on healthcare policies. The objective of this study was to evaluate the factors associated with in-hospital mortality in patients with a laboratory-confirmed Escherichia coli, Klebsiella or Pseudomonas aeruginosa GNBSIs, with data obtained from the enhanced data capture for the surveillance of GNBSIs. All patients with a laboratory-confirmed GNBSI at a single centre, admitted between April 2017 and March 2019, were included in this retrospective observational study. Demographic and recent exposure to healthcare risk factors were collected and assessed for the association with in-hospital mortality. In 1113 patients with laboratory-confirmed GNBSIs, the in-hospital mortality rate was 13%. Multivariable analysis confirmed that patients with respiratory (OR = 3.73, 95%CI = 2.05–6.76), gastrointestinal (2.61; 1.22–5.58) or skin (3.61; 1.24–10.54) infection primary focus had a greater risk of in-hospital mortality, compared to upper urinary tract infections. Increased risk of in-hospital mortality was also observed in patients with hospital-onset GNBSIs (OR = 1.87; 1.17–2.97) compared with community-onset healthcare acquired GNBSIs, or who were on dialysis at the time of the GNBSI (3.28; 1.01–10.14), as well as in patients who had recently been discharged from hospital (1.55; 1.01–2.38), or had a vascular device recently manipulated (2.41; 1.01–5.74). Results confirm that the data obtained from the enhanced data capture for GNBSIs in England can predict in-hospital mortality in patients with a GNBSI. Several factors associated with an increased risk of in-hospital mortality have been identified. Results should be reported back to clinicians in order to identify patients at a greater risk of dying in-hospital who may benefit from further monitoring.

Publisher

Public Library of Science (PLoS)

Subject

Multidisciplinary

Reference43 articles.

1. Pathologic Difference between Sepsis and Bloodstream Infections;LE Huerta;The journal of applied laboratory medicine,2019

2. Epidemiology of Escherichia coli bacteraemia in England: results of an enhanced sentinel surveillance programme;J Abernethy;The Journal of hospital infection,2017

3. NHS Improvement. Guidance on the definition of healthcare associated Gram-negative bloodstream infections: Public Health England,; 2017 [https://www.england.nhs.uk/wp-content/uploads/2020/08/HCA_BSI_definitions_guidance.pdf.

4. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study;KE Rudd;Lancet,2020

5. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3);M Singer;Jama,2016

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Speaking of sepsis: semantics, syntax, and slang;Frontiers in Medicine;2023-10-24

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3