Mortality rate and factors associated with mortality of carbapenem-resistant Enterobacteriaceae infection
Background: Carbapenem-resistant Enterobacteriaceae (CRE) is a serious pathogen with high mortality. Recognition of factors associated with mortality and treating these modifiable factors are crucial to reducing mortality. Objective: To determine the 30-day mortality and factors associated with a 30...
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| Format: | Article |
| Language: | English |
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AboutScience Srl
2023-10-01
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| Series: | Drug Target Insights |
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| Online Access: | https://journals.aboutscience.eu/index.php/dti/article/view/2622 |
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| author | Apichart So-ngern Naphol Osaithai Atibordee Meesing Worawat Chumpangern |
| author_facet | Apichart So-ngern Naphol Osaithai Atibordee Meesing Worawat Chumpangern |
| author_sort | Apichart So-ngern |
| collection | DOAJ |
| description | Background: Carbapenem-resistant Enterobacteriaceae (CRE) is a serious pathogen with high mortality. Recognition of factors associated with mortality and treating these modifiable factors are crucial to reducing mortality.
Objective: To determine the 30-day mortality and factors associated with a 30-day mortality of CRE infection.
Methods: A retrospective cohort study was conducted between January 1, 2015, and December 31, 2019. All patients diagnosed with CRE infection aged ≥18 years were included. Multivariate logistic regression was used for evaluating the factors associated with 30-day mortality and presented as adjusted odds ratio (aOR) with 95% confidence interval (CI).
Result: One hundred and ninety-four patients were enrolled. The 30-day mortality occurred in 75 patients (38.7%). The common antibiotic regimen was monotherapy and combination of carbapenem, colistin, amikacin, tigecycline, and fosfomycin. CRE isolates were susceptible to tigecycline (93.8%), colistin (91.8%), fosfomycin (89.2%), and amikacin (89.2%). The independent factors associated with 30-day mortality were an increasing simplified acute physiology (SAP) II score (aOR 1.11, 95% CI 1.05-1.16, p < 0.001), sepsis at time of CRE infection diagnosis (aOR 7.93, 95% CI 2.21-28.51, p = 0.002), pneumonia (aOR 4.48, 95% CI 1.61-12.44, p = 0.004), monotherapy (aOR 4.69, 95% CI 1.71-12.85, p = 0.003), and improper empiric antibiotic (aOR 5.13, 95% CI 1.83-14.40, p = 0.002).
Conclusion: The overall 30-day mortality of CRE infection was high. The factors associated with mortality were an increasing SAP II score, sepsis at time of CRE infection diagnosis, pneumonia, monotherapy, and improper empiric antibiotic. The study suggested that proper empiric antibiotic and combination antibiotics might reduce mortality from CRE infection.
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| first_indexed | 2024-03-11T14:28:09Z |
| format | Article |
| id | doaj.art-5e5599a4811449399a20e26ef55413bd |
| institution | Directory Open Access Journal |
| issn | 1177-3928 |
| language | English |
| last_indexed | 2024-03-11T14:28:09Z |
| publishDate | 2023-10-01 |
| publisher | AboutScience Srl |
| record_format | Article |
| series | Drug Target Insights |
| spelling | doaj.art-5e5599a4811449399a20e26ef55413bd2023-10-31T12:55:17ZengAboutScience SrlDrug Target Insights1177-39282023-10-0117110.33393/dti.2023.2622Mortality rate and factors associated with mortality of carbapenem-resistant Enterobacteriaceae infectionApichart So-ngern0Naphol Osaithai1Atibordee Meesing2Worawat Chumpangern3Division of Sleep Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - ThailandDepartment of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - ThailandDivision of Infectious Diseases and Tropical Medicines, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand and Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen - ThailandDivision of Pulmonary Medicine and Pulmonary Critical Care Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - ThailandBackground: Carbapenem-resistant Enterobacteriaceae (CRE) is a serious pathogen with high mortality. Recognition of factors associated with mortality and treating these modifiable factors are crucial to reducing mortality. Objective: To determine the 30-day mortality and factors associated with a 30-day mortality of CRE infection. Methods: A retrospective cohort study was conducted between January 1, 2015, and December 31, 2019. All patients diagnosed with CRE infection aged ≥18 years were included. Multivariate logistic regression was used for evaluating the factors associated with 30-day mortality and presented as adjusted odds ratio (aOR) with 95% confidence interval (CI). Result: One hundred and ninety-four patients were enrolled. The 30-day mortality occurred in 75 patients (38.7%). The common antibiotic regimen was monotherapy and combination of carbapenem, colistin, amikacin, tigecycline, and fosfomycin. CRE isolates were susceptible to tigecycline (93.8%), colistin (91.8%), fosfomycin (89.2%), and amikacin (89.2%). The independent factors associated with 30-day mortality were an increasing simplified acute physiology (SAP) II score (aOR 1.11, 95% CI 1.05-1.16, p < 0.001), sepsis at time of CRE infection diagnosis (aOR 7.93, 95% CI 2.21-28.51, p = 0.002), pneumonia (aOR 4.48, 95% CI 1.61-12.44, p = 0.004), monotherapy (aOR 4.69, 95% CI 1.71-12.85, p = 0.003), and improper empiric antibiotic (aOR 5.13, 95% CI 1.83-14.40, p = 0.002). Conclusion: The overall 30-day mortality of CRE infection was high. The factors associated with mortality were an increasing SAP II score, sepsis at time of CRE infection diagnosis, pneumonia, monotherapy, and improper empiric antibiotic. The study suggested that proper empiric antibiotic and combination antibiotics might reduce mortality from CRE infection. https://journals.aboutscience.eu/index.php/dti/article/view/262230-Day mortalityCarbapenem-resistant EnterobacteriaceaeFactors |
| spellingShingle | Apichart So-ngern Naphol Osaithai Atibordee Meesing Worawat Chumpangern Mortality rate and factors associated with mortality of carbapenem-resistant Enterobacteriaceae infection Drug Target Insights 30-Day mortality Carbapenem-resistant Enterobacteriaceae Factors |
| title | Mortality rate and factors associated with mortality of carbapenem-resistant Enterobacteriaceae infection |
| title_full | Mortality rate and factors associated with mortality of carbapenem-resistant Enterobacteriaceae infection |
| title_fullStr | Mortality rate and factors associated with mortality of carbapenem-resistant Enterobacteriaceae infection |
| title_full_unstemmed | Mortality rate and factors associated with mortality of carbapenem-resistant Enterobacteriaceae infection |
| title_short | Mortality rate and factors associated with mortality of carbapenem-resistant Enterobacteriaceae infection |
| title_sort | mortality rate and factors associated with mortality of carbapenem resistant enterobacteriaceae infection |
| topic | 30-Day mortality Carbapenem-resistant Enterobacteriaceae Factors |
| url | https://journals.aboutscience.eu/index.php/dti/article/view/2622 |
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