Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study
Abstract 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 patt...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-06496-8 |
| _version_ | 1818444045280608256 |
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| author | Renato Pascale Silvia Corcione Linda Bussini Livia Pancaldi Daniele Roberto Giacobbe Simone Ambretti Tommaso Lupia Cristina Costa Anna Marchese Francesco Giuseppe De Rosa Matteo Bassetti Claudio Viscoli Michele Bartoletti Maddalena Giannella Pierluigi Viale |
| author_facet | Renato Pascale Silvia Corcione Linda Bussini Livia Pancaldi Daniele Roberto Giacobbe Simone Ambretti Tommaso Lupia Cristina Costa Anna Marchese Francesco Giuseppe De Rosa Matteo Bassetti Claudio Viscoli Michele Bartoletti Maddalena Giannella Pierluigi Viale |
| author_sort | Renato Pascale |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-14T19:09:41Z |
| format | Article |
| id | doaj.art-0274158cf6a147c2875413da6807419e |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-14T19:09:41Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-0274158cf6a147c2875413da6807419e2022-12-21T22:50:45ZengBMCBMC Infectious Diseases1471-23342021-08-012111810.1186/s12879-021-06496-8Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort studyRenato Pascale0Silvia Corcione1Linda Bussini2Livia Pancaldi3Daniele Roberto Giacobbe4Simone Ambretti5Tommaso Lupia6Cristina Costa7Anna Marchese8Francesco Giuseppe De Rosa9Matteo Bassetti10Claudio Viscoli11Michele Bartoletti12Maddalena Giannella13Pierluigi Viale14Infectious Diseases Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di BolognaDepartment of Medical Sciences, Infectious Diseases, University of TurinInfectious Diseases Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di BolognaInfectious Diseases Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di BolognaInfectious Diseases Unit, Ospedale Policlinico San Martino-IRCCSOperative Unit of Clinical Microbiology, Policlinico Sant’Orsola Malpighi, University of BolognaDepartment of Medical Sciences, Infectious Diseases, University of TurinDepartment of Public Health and Pediatrics, Laboratory of Microbiology and Virology, Città della Salute e della Scienza Hospital, University of TurinDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of GenoaDepartment of Medical Sciences, Infectious Diseases, University of TurinInfectious Diseases Unit, Ospedale Policlinico San Martino-IRCCSInfectious Diseases Unit, Ospedale Policlinico San Martino-IRCCSInfectious Diseases Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di BolognaInfectious Diseases Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di BolognaInfectious Diseases Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di BolognaAbstract 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.https://doi.org/10.1186/s12879-021-06496-8Bloodstream infectionNon-fermentative gram-negative bacteriaMultidrug resistanceDifficult to treat resistanceTherapeutic management30-Day mortality |
| spellingShingle | Renato Pascale Silvia Corcione Linda Bussini Livia Pancaldi Daniele Roberto Giacobbe Simone Ambretti Tommaso Lupia Cristina Costa Anna Marchese Francesco Giuseppe De Rosa Matteo Bassetti Claudio Viscoli Michele Bartoletti Maddalena Giannella Pierluigi Viale Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study BMC Infectious Diseases Bloodstream infection Non-fermentative gram-negative bacteria Multidrug resistance Difficult to treat resistance Therapeutic management 30-Day mortality |
| title | Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study |
| title_full | Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study |
| title_fullStr | Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study |
| title_full_unstemmed | Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study |
| title_short | Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study |
| title_sort | non fermentative gram negative bloodstream infection in northern italy a multicenter cohort study |
| topic | Bloodstream infection Non-fermentative gram-negative bacteria Multidrug resistance Difficult to treat resistance Therapeutic management 30-Day mortality |
| url | https://doi.org/10.1186/s12879-021-06496-8 |
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