The Effect of Antibiotic Resistance and Inappropriate Empirical Antibiotic Therapy on 3-Day and 28-Day Mortality in Bacteremic Patients in the Intensive Care Unit: 5-Year Retrospective Analysis
Aim: The aim of this study was to examine the effects of antibiotic resistance, empirical antibiotic therapy, and comorbid diseases on 3-day and 28-day mortality in patients with bloodstream infections. Material and Methods: Files of the patients with positive blood cultures results, between January...
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| Format: | Article |
| Language: | English |
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Duzce University
2022-08-01
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| Series: | Düzce Tıp Fakültesi Dergisi |
| Subjects: | |
| Online Access: | https://dergipark.org.tr/en/download/article-file/2237439 |
| _version_ | 1797668837059985408 |
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| author | İlker Ödemiş Tuğba Arslan Gülen |
| author_facet | İlker Ödemiş Tuğba Arslan Gülen |
| author_sort | İlker Ödemiş |
| collection | DOAJ |
| description | Aim: The aim of this study was to examine the effects of antibiotic resistance, empirical antibiotic therapy, and comorbid diseases on 3-day and 28-day mortality in patients with bloodstream infections.
Material and Methods: Files of the patients with positive blood cultures results, between January 1st, 2015, and January 1st, 2020 were analyzed retrospectively. The primary outcome was 3-day mortality and the secondary outcome was 28-day mortality.
Results: A total of 515 patients, 208 (40.4%) female and 307 (59.6%) male, were included in the study. The median age of the patients was 73 (range, 18-95) years. Vancomycin resistance was detected in 8 (3.4%) of 233 gram-positive bacteria. Third-generation cephalosporin, meropenem, and colistin resistance rates of the 282 gram-negative bacteria were found to be 72.7% (n=205), 53.2% (n=150), and 9.9% (n=28), respectively. The 3-day and 28-day mortality rates were 14.4% (n=74) and 64.3% (n=331), respectively. Charlson comorbidity index score (CCIS) (p=0.001) and acute physiology and chronic health evaluation (APACHE) II score (p=0.019) were found to be risk factors for 3-day mortality. Risk factors for 28-day mortality were; age (p<0.001), CCIS (p<0.001), APACHE II score (p=0.001), chronic obstructive pulmonary disease (p=0.007), hospital-acquired infection (p=0.033), and inappropriate antibiotic therapy (p<0.001).
Conclusion: There was no association between antibiotic resistance and mortality, but inappropriate antibiotic treatment was found to increase the risk of 28-day mortality. In addition, since high CCIS and APACHE II scores increase the risk of both 3-day and 28-day mortality, we think that considering these scoring systems will reduce the risk of mortality. |
| first_indexed | 2024-03-11T20:35:16Z |
| format | Article |
| id | doaj.art-601889393ba543f4a30bfefbc0fc2057 |
| institution | Directory Open Access Journal |
| issn | 1307-671X |
| language | English |
| last_indexed | 2024-03-11T20:35:16Z |
| publishDate | 2022-08-01 |
| publisher | Duzce University |
| record_format | Article |
| series | Düzce Tıp Fakültesi Dergisi |
| spelling | doaj.art-601889393ba543f4a30bfefbc0fc20572023-10-02T06:46:06ZengDuzce UniversityDüzce Tıp Fakültesi Dergisi1307-671X2022-08-0124218719210.18678/dtfd.106939397The Effect of Antibiotic Resistance and Inappropriate Empirical Antibiotic Therapy on 3-Day and 28-Day Mortality in Bacteremic Patients in the Intensive Care Unit: 5-Year Retrospective Analysisİlker Ödemiş0Tuğba Arslan Gülen1NİĞDE ÖMER HALİSDEMİR ÜNİVERSİTESİ, TIP FAKÜLTESİNİĞDE ÖMER HALİSDEMİR ÜNİVERSİTESİ, TIP FAKÜLTESİAim: The aim of this study was to examine the effects of antibiotic resistance, empirical antibiotic therapy, and comorbid diseases on 3-day and 28-day mortality in patients with bloodstream infections. Material and Methods: Files of the patients with positive blood cultures results, between January 1st, 2015, and January 1st, 2020 were analyzed retrospectively. The primary outcome was 3-day mortality and the secondary outcome was 28-day mortality. Results: A total of 515 patients, 208 (40.4%) female and 307 (59.6%) male, were included in the study. The median age of the patients was 73 (range, 18-95) years. Vancomycin resistance was detected in 8 (3.4%) of 233 gram-positive bacteria. Third-generation cephalosporin, meropenem, and colistin resistance rates of the 282 gram-negative bacteria were found to be 72.7% (n=205), 53.2% (n=150), and 9.9% (n=28), respectively. The 3-day and 28-day mortality rates were 14.4% (n=74) and 64.3% (n=331), respectively. Charlson comorbidity index score (CCIS) (p=0.001) and acute physiology and chronic health evaluation (APACHE) II score (p=0.019) were found to be risk factors for 3-day mortality. Risk factors for 28-day mortality were; age (p<0.001), CCIS (p<0.001), APACHE II score (p=0.001), chronic obstructive pulmonary disease (p=0.007), hospital-acquired infection (p=0.033), and inappropriate antibiotic therapy (p<0.001). Conclusion: There was no association between antibiotic resistance and mortality, but inappropriate antibiotic treatment was found to increase the risk of 28-day mortality. In addition, since high CCIS and APACHE II scores increase the risk of both 3-day and 28-day mortality, we think that considering these scoring systems will reduce the risk of mortality.https://dergipark.org.tr/en/download/article-file/2237439mortalitysepsiscritical carebacteraemiaantibioticresistancemortalitesepsisyoğun bakımbakteriyemiantibiyotikdirenç |
| spellingShingle | İlker Ödemiş Tuğba Arslan Gülen The Effect of Antibiotic Resistance and Inappropriate Empirical Antibiotic Therapy on 3-Day and 28-Day Mortality in Bacteremic Patients in the Intensive Care Unit: 5-Year Retrospective Analysis Düzce Tıp Fakültesi Dergisi mortality sepsis critical care bacteraemia antibiotic resistance mortalite sepsis yoğun bakım bakteriyemi antibiyotik direnç |
| title | The Effect of Antibiotic Resistance and Inappropriate Empirical Antibiotic Therapy on 3-Day and 28-Day Mortality in Bacteremic Patients in the Intensive Care Unit: 5-Year Retrospective Analysis |
| title_full | The Effect of Antibiotic Resistance and Inappropriate Empirical Antibiotic Therapy on 3-Day and 28-Day Mortality in Bacteremic Patients in the Intensive Care Unit: 5-Year Retrospective Analysis |
| title_fullStr | The Effect of Antibiotic Resistance and Inappropriate Empirical Antibiotic Therapy on 3-Day and 28-Day Mortality in Bacteremic Patients in the Intensive Care Unit: 5-Year Retrospective Analysis |
| title_full_unstemmed | The Effect of Antibiotic Resistance and Inappropriate Empirical Antibiotic Therapy on 3-Day and 28-Day Mortality in Bacteremic Patients in the Intensive Care Unit: 5-Year Retrospective Analysis |
| title_short | The Effect of Antibiotic Resistance and Inappropriate Empirical Antibiotic Therapy on 3-Day and 28-Day Mortality in Bacteremic Patients in the Intensive Care Unit: 5-Year Retrospective Analysis |
| title_sort | effect of antibiotic resistance and inappropriate empirical antibiotic therapy on 3 day and 28 day mortality in bacteremic patients in the intensive care unit 5 year retrospective analysis |
| topic | mortality sepsis critical care bacteraemia antibiotic resistance mortalite sepsis yoğun bakım bakteriyemi antibiyotik direnç |
| url | https://dergipark.org.tr/en/download/article-file/2237439 |
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