Dynamic monitoring of neutrophil/lymphocyte ratio, APACHE II score, and SOFA score predict prognosis and drug resistance in patients with Acinetobacter baumannii–calcoaceticus complex bloodstream infection: a single-center retrospective study
ObjectiveThis study aimed to evaluate the clinical value of dynamic monitoring of neutrophil/lymphocyte ratio (NLR), APACHE II (Acute Physiology and Chronic Health Evaluation II) score, and Sequential Organ Failure Assessment (SOFA) score in predicting 28-day prognosis and drug resistance in patient...
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2024.1296059/full |
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| author | Zhiyong Wei Lina Zhao Jia Yan Xuejie Wang Qun Li Yuanyuan Ji Jie Liu Yan Cui Keliang Xie Keliang Xie |
| author_facet | Zhiyong Wei Lina Zhao Jia Yan Xuejie Wang Qun Li Yuanyuan Ji Jie Liu Yan Cui Keliang Xie Keliang Xie |
| author_sort | Zhiyong Wei |
| collection | DOAJ |
| description | ObjectiveThis study aimed to evaluate the clinical value of dynamic monitoring of neutrophil/lymphocyte ratio (NLR), APACHE II (Acute Physiology and Chronic Health Evaluation II) score, and Sequential Organ Failure Assessment (SOFA) score in predicting 28-day prognosis and drug resistance in patients with bloodstream infection with Acinetobacter baumannii–calcoaceticus complex (Abc complex).Patients and methodsIn this research, individuals admitted to Tianjin Medical University General Hospital from January 2017 to March 2023 with bloodstream infections and a minimum of one Abc complex positive blood culture were chosen. The risk factors for the 28-day prognosis and drug resistance were analyzed using logistic regression. The NLR, APACHE II score, and SOFA score were evaluated for predicting 28-day prognosis and drug resistance using an ROC curve analysis. The data were analyzed using R Studio to find correlations and conduct survival analysis with the Kaplan–Meier method.ResultsThe final statistical analysis included a total of 129 patients with bloodstream infections caused by Abc complex. Independent risk factors predicting mortality within 28 days were identified as follows: the SOFA score and APACHE II scores at 24 h, and APACHE II scores at 72 h after the onset of blood infection (p < 0.05). NLR, SOFA score, and APACHE II score did not predict drug resistance. Patients with Carbapenem-resistant Acinetobacter baumannii–calcoaceticus complex (CRAB) had shorter survival times than those with carbapenem-sensitive strains (40.77 days vs. 47.65 days, respectively, p = 0.0032).ConclusionThe prognosis of Abc complex bloodstream infection is affected by both SOFA and APACHE II scores. Both scoring systems have similar prognostic values at different time points after infection, but for computational convenience, it is recommended to use the SOFA score. NLR exhibits limited effectiveness in predicting mortality within 28 days. Carbapenem-resistant individuals with Abc complex experience significantly reduced survival time. None of the three factors—SOFA score, APACHE II score, and NLR—can early predict the occurrence of CRAB infections effectively. |
| first_indexed | 2024-03-08T12:07:45Z |
| format | Article |
| id | doaj.art-70f5480a10894c2fa6426fa40e0204b2 |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-03-08T12:07:45Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Microbiology |
| spelling | doaj.art-70f5480a10894c2fa6426fa40e0204b22024-01-23T04:45:20ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2024-01-011510.3389/fmicb.2024.12960591296059Dynamic monitoring of neutrophil/lymphocyte ratio, APACHE II score, and SOFA score predict prognosis and drug resistance in patients with Acinetobacter baumannii–calcoaceticus complex bloodstream infection: a single-center retrospective studyZhiyong Wei0Lina Zhao1Jia Yan2Xuejie Wang3Qun Li4Yuanyuan Ji5Jie Liu6Yan Cui7Keliang Xie8Keliang Xie9Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Pathogen Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Anesthesiology, Tianjin Institute of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, ChinaObjectiveThis study aimed to evaluate the clinical value of dynamic monitoring of neutrophil/lymphocyte ratio (NLR), APACHE II (Acute Physiology and Chronic Health Evaluation II) score, and Sequential Organ Failure Assessment (SOFA) score in predicting 28-day prognosis and drug resistance in patients with bloodstream infection with Acinetobacter baumannii–calcoaceticus complex (Abc complex).Patients and methodsIn this research, individuals admitted to Tianjin Medical University General Hospital from January 2017 to March 2023 with bloodstream infections and a minimum of one Abc complex positive blood culture were chosen. The risk factors for the 28-day prognosis and drug resistance were analyzed using logistic regression. The NLR, APACHE II score, and SOFA score were evaluated for predicting 28-day prognosis and drug resistance using an ROC curve analysis. The data were analyzed using R Studio to find correlations and conduct survival analysis with the Kaplan–Meier method.ResultsThe final statistical analysis included a total of 129 patients with bloodstream infections caused by Abc complex. Independent risk factors predicting mortality within 28 days were identified as follows: the SOFA score and APACHE II scores at 24 h, and APACHE II scores at 72 h after the onset of blood infection (p < 0.05). NLR, SOFA score, and APACHE II score did not predict drug resistance. Patients with Carbapenem-resistant Acinetobacter baumannii–calcoaceticus complex (CRAB) had shorter survival times than those with carbapenem-sensitive strains (40.77 days vs. 47.65 days, respectively, p = 0.0032).ConclusionThe prognosis of Abc complex bloodstream infection is affected by both SOFA and APACHE II scores. Both scoring systems have similar prognostic values at different time points after infection, but for computational convenience, it is recommended to use the SOFA score. NLR exhibits limited effectiveness in predicting mortality within 28 days. Carbapenem-resistant individuals with Abc complex experience significantly reduced survival time. None of the three factors—SOFA score, APACHE II score, and NLR—can early predict the occurrence of CRAB infections effectively.https://www.frontiersin.org/articles/10.3389/fmicb.2024.1296059/fulldisease severity scoreneutrophil/lymphocyte ratio (NLR)Carbapenem-resistant Acinetobacter baumannii–calcoaceticus complex (CRAB)risk factorbloodstream infection (BSI)sepsis |
| spellingShingle | Zhiyong Wei Lina Zhao Jia Yan Xuejie Wang Qun Li Yuanyuan Ji Jie Liu Yan Cui Keliang Xie Keliang Xie Dynamic monitoring of neutrophil/lymphocyte ratio, APACHE II score, and SOFA score predict prognosis and drug resistance in patients with Acinetobacter baumannii–calcoaceticus complex bloodstream infection: a single-center retrospective study Frontiers in Microbiology disease severity score neutrophil/lymphocyte ratio (NLR) Carbapenem-resistant Acinetobacter baumannii–calcoaceticus complex (CRAB) risk factor bloodstream infection (BSI) sepsis |
| title | Dynamic monitoring of neutrophil/lymphocyte ratio, APACHE II score, and SOFA score predict prognosis and drug resistance in patients with Acinetobacter baumannii–calcoaceticus complex bloodstream infection: a single-center retrospective study |
| title_full | Dynamic monitoring of neutrophil/lymphocyte ratio, APACHE II score, and SOFA score predict prognosis and drug resistance in patients with Acinetobacter baumannii–calcoaceticus complex bloodstream infection: a single-center retrospective study |
| title_fullStr | Dynamic monitoring of neutrophil/lymphocyte ratio, APACHE II score, and SOFA score predict prognosis and drug resistance in patients with Acinetobacter baumannii–calcoaceticus complex bloodstream infection: a single-center retrospective study |
| title_full_unstemmed | Dynamic monitoring of neutrophil/lymphocyte ratio, APACHE II score, and SOFA score predict prognosis and drug resistance in patients with Acinetobacter baumannii–calcoaceticus complex bloodstream infection: a single-center retrospective study |
| title_short | Dynamic monitoring of neutrophil/lymphocyte ratio, APACHE II score, and SOFA score predict prognosis and drug resistance in patients with Acinetobacter baumannii–calcoaceticus complex bloodstream infection: a single-center retrospective study |
| title_sort | dynamic monitoring of neutrophil lymphocyte ratio apache ii score and sofa score predict prognosis and drug resistance in patients with acinetobacter baumannii calcoaceticus complex bloodstream infection a single center retrospective study |
| topic | disease severity score neutrophil/lymphocyte ratio (NLR) Carbapenem-resistant Acinetobacter baumannii–calcoaceticus complex (CRAB) risk factor bloodstream infection (BSI) sepsis |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2024.1296059/full |
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