Reappraisal of attributable mortality in critically ill patients with nosocomial bacteraemia involving Pseudomonas aeruginosa

被引:63
作者
Blot, S [1 ]
Vandewoude, K [1 ]
Hoste, E [1 ]
Colardyn, F [1 ]
机构
[1] State Univ Ghent Hosp, Dept Intens Care, B-9000 Ghent, Belgium
关键词
attributable mortality; bacteraemia; outcome; Pseudomonas spp; intensive care; APACHE II;
D O I
10.1053/jhin.2002.1329
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
In a retrospective study, population characteristics and outcome were investigated in intensive care unit (ICU) patients with hospital-acquired Pseudomonas aeruginosa bacteraemia admitted over a seven-year period (January 1992 through December 1998). A matched cohort study was performed in which all ICU patients with P. aeruginosa bacteraemia were defined as cases (N = 53). Matching (1:2 ratio) of the controls (N = 106) was based on the APACHE II classification: an equal APACHE II score ( 1 point) and an equal diagnostic category. Patients with P. aeruginosa bacteraemia had a higher incidence of acute respiratory failure, haemodynamic instability, a longer ICU stay and length of ventilator dependence (P<0.05). In-hospital mortalities for cases and controls were 62.3 vs. 47.2% respectively (P = 0.073). Thus, the attributable mortality was 15.1% (95% confidence intervals: -1.0-31.2). In a multivariate survival analysis the APACHE II score was the only variable independently associated with mortality. In conclusion, P. aeruginosa bacteraemia is associated with a clinically relevant attributable mortality (15%). However, we could not find statistical evidence of P. aeruginosa being an independent predictor of mortality. (C) 2003 The Hospital Infection Society.
引用
收藏
页码:18 / 24
页数:7
相关论文
共 28 条
[1]  
ANDERSON R, 1978, ARCH SURG-CHICAGO, V106, P692
[2]  
ANDRIOLE VT, 1979, J LAB CLIN MED, V94, P196
[3]  
BALTCH AL, 1977, AM J MED SCI, V274, P119, DOI 10.1097/00000441-197709000-00002
[4]   Endemicity, molecular diversity and colonisation routes of Pseudomonas aeruginosa in intensive care units [J].
Bertrand, X ;
Thouverez, M ;
Talon, D ;
Boillot, A ;
Capellier, G ;
Floriot, C ;
Hélias, JP .
INTENSIVE CARE MEDICINE, 2001, 27 (08) :1263-1268
[5]  
BISBE J, 1988, REV INFECT DIS, V10, P629
[6]   Nosocomial bacteremia caused by antibiotic-resistant gram-negative bacteria in critically ill patients: Clinical outcome and length of hospitalization [J].
Blot, S ;
Vandewoude, K ;
De Bacquer, D ;
Colardyn, F .
CLINICAL INFECTIOUS DISEASES, 2002, 34 (12) :1600-1606
[7]   Clinical impact of nosocomial Klebsiella bacteremia in critically ill patients [J].
Blot, SI ;
Vandewoude, KH ;
Colardyn, FA .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2002, 21 (06) :471-473
[8]   Outcome and attributable mortality in critically ill patients with bacteremia involving methicillin-susceptible and methicillin-resistant Staphylococcus aureus [J].
Blot, SI ;
Vandewoude, KH ;
Hoste, EA ;
Colardyn, FA .
ARCHIVES OF INTERNAL MEDICINE, 2002, 162 (19) :2229-2235
[9]   Effects of nosocomial candidemia on outcomes of critically ill patients [J].
Blot, SI ;
Vandewoude, KH ;
Hoste, EA ;
Colardyn, FA .
AMERICAN JOURNAL OF MEDICINE, 2002, 113 (06) :480-485
[10]   PSEUDOMONAS BACTEREMIA - RETROSPECTIVE ANALYSIS OF 410 EPISODES [J].
BODEY, GP ;
JADEJA, L ;
ELTING, L .
ARCHIVES OF INTERNAL MEDICINE, 1985, 145 (09) :1621-1629