Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study

被引:19
作者
Pascale, Renato [1 ]
Corcione, Silvia [2 ]
Bussini, Linda [1 ]
Pancaldi, Livia [1 ]
Giacobbe, Daniele Roberto [3 ,4 ]
Ambretti, Simone [5 ]
Lupia, Tommaso [2 ]
Costa, Cristina [6 ]
Marchese, Anna [7 ,8 ]
De Rosa, Francesco Giuseppe [2 ]
Bassetti, Matteo [3 ]
Viscoli, Claudio [3 ]
Bartoletti, Michele [1 ]
Giannella, Maddalena [1 ]
Viale, Pierluigi [1 ]
机构
[1] IRCCS Azienda Osped Univ Bologna, Dept Med & Surg Sci, Infect Dis Unit, Via Massarenti 11, I-40137 Bologna, Italy
[2] Univ Turin, Dept Med Sci, Infect Dis, Turin, Italy
[3] Osped Policlin San Martino IRCCS, Infect Dis Unit, Genoa, Italy
[4] Univ Genoa, Dept Hlth Sci DISSAL, Genoa, Italy
[5] Univ Bologna, Operat Unit Clin Microbiol, Policlin St Orsola Malpighi, Bologna, Italy
[6] Univ Turin, Citta Salute & Sci Hosp, Lab Microbiol & Virol, Dept Publ Hlth & Pediat, Turin, Italy
[7] Univ Genoa, Dept Surg Sci & Integrated Diagnost DISC, Genoa, Italy
[8] Osped Policlin San Martino IRCCS, Microbiol Unit, Genoa, Italy
关键词
Bloodstream infection; Non-fermentative gram-negative bacteria; Multidrug resistance; Difficult to treat resistance; Therapeutic management; 30-Day mortality; PSEUDOMONAS-AERUGINOSA; DEFINITION;
D O I
10.1186/s12879-021-06496-8
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background The management of non-fermentative gram-negative bloodstream infection (NFGN-BSI) offers numerous challenges. In this study the aim is to analyse a large cohort of patients with NFGN-BSI recruited in the northern Italy to describe epidemiology, etiological and susceptibility pattern, therapeutic management and outcome. Methods Multicentre retrospective cohort study of patients hospitalised at three large teaching hospitals in northern Italy in a fourth year period. Results 355 BSI episodes were analyzed, due to P. aeruginosa (72.7%), A. baumannii (16.6%), and Stenotrophomonas maltophilia (10.7%). Overall, 21.4% of isolates were defined as DTR, highest rate among A. baumannii (64.4%). All-cause 30-day mortality rate was 17.5%. Rates of XDR or DTR A. baumannii isolation were significantly higher in non-surviving patients. Independent risk factors for 30-day mortality were: age (HR 1.03, 95%CI 1.00-1.04, p = 0.003), septic shock (HR 2.84, 95%CI 1.67-4.82, p < 0.001) and BSI due to Acinetobacter baumannii (HR 2.23, 95%CI 1.27-3.94, p = 0.005). Conclusion The overall prevalence of DTR was high in the NFGN BSI cohort analyzied, mainly among Acinetobacter baumannii episodes (64.4%). Acinetobacter baumannii is showed to be an independent predictor of mortality. These evidences marked the urgent need of new therapeutic options against this pathogen. Trial registration number: 79/2017/O/OssN. Approved: March14th, 2017.
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页数:8
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