Predicting resistant etiology in hospitalized patients with blood cultures positive for Gram-negative bacilli

Salvatore Corrao, Alessio Farcomeni, Ercole Concia, Emanuela Foglia, Giorgio Bonardi, Giusy Tiseo, Elisabetta Garagiola, Maurizia Gambacorta, Fabrizio Colombo, Micaela La Regina, Pierangelo Clerici, Salvatore Corrao, Mauro Campanini, Marco Falcone, Antonino Mazzone, Francesco Dentali

Risultato della ricerca: Article

5 Citazioni (Scopus)

Abstract

Objective: To develop a risk-scoring tool to predict multidrug-resistant (MDR) etiology in patients with bloodstream infections (BSI) caused by Gram-negative bacilli (GNB). Methods: A prospective multicenter study analyzed patients with BSI hospitalized in 31 Internal Medicine wards in Italy from March 2012 to December 2012. Patients with BSI caused by MDR-GNB (non-susceptible to at least one agent in three antimicrobial categories) were compared to those with BSI due to susceptible GNB. A logistic regression to identify predictive factors of MDR-GNB was performed and the odds ratio (OR) were calculated. A score to predict the risk of MDR was developed. Results: Of 533 BSI episodes, 253 (47.5%) were caused by GNB. Among GNB-BSI, 122 (48.2%) were caused by MDR-GNB while 131 (51.8%) by non-MDR GNB. At multivariate analysis transfer from long-term care facility (OR 9.013, 95% CI 1.089–74.579, p = 0.041), hospitalization in the last 3 months (OR 2.882, 95% CI 1.580–5.259, p = 0.001), urinary catheter (OR 2.315, 95% CI 1.202–4.459, p = 0.012), antibiotic therapy in the last 3 months (OR 1.882, 95% CI 1.041–3.405, p = 0.036), age ≥ 75 years (OR 1.866, 95% CI 1.076–3.237, p = 0.026) were factors independently associated with MDR etiology. A score ranging from 0 to 10 was useful to recognize patients at lowest risk (0 points: Negative Likelihood Ratio 0.10) and those at highest risk (>6 points, Positive Likelihood Ratio 11.8) of GNB bacteremia due to a MDR strain. Conclusions: Specific predictors of MDR etiology are useful to calculate probabilities of MDR etiology among hospitalized patients with blood cultures positive for GNB.
Lingua originaleEnglish
pagine (da-a)21-28
Numero di pagine8
RivistaEuropean Journal of Internal Medicine
Volume53
Stato di pubblicazionePublished - 2018

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Fingerprint Entra nei temi di ricerca di 'Predicting resistant etiology in hospitalized patients with blood cultures positive for Gram-negative bacilli'. Insieme formano una fingerprint unica.

Cita questo