Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China
Background: Hospital-acquired pneumonia (HAP) remains an important cause of morbidity and mortality despite advances in antimicrobial therapy. The emergence of Gram-negative bacteria (GNB) is of major concern. The objective of this study was to describe the epidemiology, microbiology, and predictors...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-09-01
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| Series: | Journal of Infection and Public Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034119300851 |
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| author | Ding-Yun Feng Yu-Qi Zhou Xiao-Ling Zou Mi Zhou Wen-Bin Wu Xiao-Xia Chen Yan-Hong Wang Tian-Tuo Zhang |
| author_facet | Ding-Yun Feng Yu-Qi Zhou Xiao-Ling Zou Mi Zhou Wen-Bin Wu Xiao-Xia Chen Yan-Hong Wang Tian-Tuo Zhang |
| author_sort | Ding-Yun Feng |
| collection | DOAJ |
| description | Background: Hospital-acquired pneumonia (HAP) remains an important cause of morbidity and mortality despite advances in antimicrobial therapy. The emergence of Gram-negative bacteria (GNB) is of major concern. The objective of this study was to describe the epidemiology, microbiology, and predictors of infection-related 30-day mortality in HAP with GNB. Methods: We performed a retrospective, single-center analysis of HAP patients with GNB occurring from January 2014 and December 2017. Univariate and multivariate analyses were performed to identify the risk factors for mortality. Results: During the observational period, there were 1472 cases of HAP; 314 cases were bacterial culture-positive, 269 cases were caused by GNB, with a predominance of Acinetobacter baumannii and Pseudomonas aeruginosa. The mortality related to GNB was 14.5% (39 deaths).In the multivariate logistic regression analysis, the risk factors for mortality were age >70 years, intensive care unit (ICU) admission, blood lymphocyte count < 0.8 × 109/L, multidrug-resistant Gram-negative bacteria(MDR-GNB) infection, and elevation of blood urea nitrogen(BUN) level. We identified these factors as significant predictors of GNB related mortality; the area under the receiver operating characteristic (ROC) curves was 0.836. Conclusion: The results provided can help clinicians in identifying individuals who are at risk of infection-related 30-day mortality in HAP with GNB. Keywords: Hospital-acquired pneumonia, Gram-negative bacteria, Predictors, Mortality |
| first_indexed | 2024-12-14T00:54:45Z |
| format | Article |
| id | doaj.art-5df0f77e16964d708529c99255f402dd |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-12-14T00:54:45Z |
| publishDate | 2019-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-5df0f77e16964d708529c99255f402dd2022-12-21T23:23:37ZengElsevierJournal of Infection and Public Health1876-03412019-09-01125630633Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in ChinaDing-Yun Feng0Yu-Qi Zhou1Xiao-Ling Zou2Mi Zhou3Wen-Bin Wu4Xiao-Xia Chen5Yan-Hong Wang6Tian-Tuo Zhang7Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Surgery Intensive Care Unit, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Medical Record, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, China; Corresponding author at: Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China.Background: Hospital-acquired pneumonia (HAP) remains an important cause of morbidity and mortality despite advances in antimicrobial therapy. The emergence of Gram-negative bacteria (GNB) is of major concern. The objective of this study was to describe the epidemiology, microbiology, and predictors of infection-related 30-day mortality in HAP with GNB. Methods: We performed a retrospective, single-center analysis of HAP patients with GNB occurring from January 2014 and December 2017. Univariate and multivariate analyses were performed to identify the risk factors for mortality. Results: During the observational period, there were 1472 cases of HAP; 314 cases were bacterial culture-positive, 269 cases were caused by GNB, with a predominance of Acinetobacter baumannii and Pseudomonas aeruginosa. The mortality related to GNB was 14.5% (39 deaths).In the multivariate logistic regression analysis, the risk factors for mortality were age >70 years, intensive care unit (ICU) admission, blood lymphocyte count < 0.8 × 109/L, multidrug-resistant Gram-negative bacteria(MDR-GNB) infection, and elevation of blood urea nitrogen(BUN) level. We identified these factors as significant predictors of GNB related mortality; the area under the receiver operating characteristic (ROC) curves was 0.836. Conclusion: The results provided can help clinicians in identifying individuals who are at risk of infection-related 30-day mortality in HAP with GNB. Keywords: Hospital-acquired pneumonia, Gram-negative bacteria, Predictors, Mortalityhttp://www.sciencedirect.com/science/article/pii/S1876034119300851 |
| spellingShingle | Ding-Yun Feng Yu-Qi Zhou Xiao-Ling Zou Mi Zhou Wen-Bin Wu Xiao-Xia Chen Yan-Hong Wang Tian-Tuo Zhang Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China Journal of Infection and Public Health |
| title | Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China |
| title_full | Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China |
| title_fullStr | Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China |
| title_full_unstemmed | Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China |
| title_short | Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China |
| title_sort | factors influencing mortality in hospital acquired pneumonia caused by gram negative bacteria in china |
| url | http://www.sciencedirect.com/science/article/pii/S1876034119300851 |
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