Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study
ABSTRACT: Objectives: The long-term outcomes of patients following Gram-negative bacteraemia (GNB) are poorly understood. Here we describe a cohort of patients with GNB over a 2-year period and determine factors associated with late mortality (death between Days 31 and 365 after detection of bacter...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716521000862 |
| _version_ | 1819098170873872384 |
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| author | Ioannis Baltas Thomas Stockdale Matija Tausan Areeba Kashif Javeria Anwar Junaid Anvar Eirini Koutoumanou David Sidebottom Veronica Garcia-Arias Melanie Wright Jane Democratis |
| author_facet | Ioannis Baltas Thomas Stockdale Matija Tausan Areeba Kashif Javeria Anwar Junaid Anvar Eirini Koutoumanou David Sidebottom Veronica Garcia-Arias Melanie Wright Jane Democratis |
| author_sort | Ioannis Baltas |
| collection | DOAJ |
| description | ABSTRACT: Objectives: The long-term outcomes of patients following Gram-negative bacteraemia (GNB) are poorly understood. Here we describe a cohort of patients with GNB over a 2-year period and determine factors associated with late mortality (death between Days 31 and 365 after detection of bacteraemia). Methods: This was a single-centre, retrospective, observational cohort study of 789 patients with confirmed Escherichia coli, Klebsiella spp. or Pseudomonas aeruginosa bacteraemia with a follow-up of 1 year. Multivariable survival analysis was used to determine risk factors for late mortality in patients who survived the initial 30-day period of infection. Results: Overall, 1-year all-cause mortality was 36.2%, with 18.1% of patients dying within 30 days and 18.1% of patients suffering late mortality. An adverse antimicrobial resistance profile [hazard ratio (HR) = 1.095 per any additional antimicrobial category, 95% confidence interval (CI) 1.018–1.178; P = 0.014] and infection with P. aeruginosa (HR = 2.08, 95% CI 1.11–3.88; P = 0.022) were independent predictors of late mortality. Other significant factors included Charlson comorbidity index and length of hospitalisation after the index blood culture. Conclusion: Patients with GNB have a poor long-term prognosis. Risk factors for greater mortality at 1 year include co-morbidity, length of hospitalisation, and infecting organism and its resistance profile. |
| first_indexed | 2024-12-22T00:26:44Z |
| format | Article |
| id | doaj.art-84b981bbaacc4d559d802fab0e8d2933 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-12-22T00:26:44Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-84b981bbaacc4d559d802fab0e8d29332022-12-21T18:45:02ZengElsevierJournal of Global Antimicrobial Resistance2213-71652021-06-0125187192Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort studyIoannis Baltas0Thomas Stockdale1Matija Tausan2Areeba Kashif3Javeria Anwar4Junaid Anvar5Eirini Koutoumanou6David Sidebottom7Veronica Garcia-Arias8Melanie Wright9Jane Democratis10Department of Medicine, Infectious Diseases and Microbiology, Frimley Health NHS Foundation Trust, Berkshire, UK; UCL, Institute of Education, London, UK; Corresponding author. Mailing address: Wexham Park Hospital, Wexham Street, Slough SL2 5PF, UK. Tel.: +44 7543 780 069.Department of Medicine, Infectious Diseases and Microbiology, Frimley Health NHS Foundation Trust, Berkshire, UKDepartment of Medicine, Royal Sussex County Hospital, Brighton, UKDepartment of Medicine, Infectious Diseases and Microbiology, Frimley Health NHS Foundation Trust, Berkshire, UKDepartment of Medicine, Infectious Diseases and Microbiology, Frimley Health NHS Foundation Trust, Berkshire, UKDepartment of Medicine, Infectious Diseases and Microbiology, Frimley Health NHS Foundation Trust, Berkshire, UKUCL, Great Ormond Street Institute of Child Health, London, UKDepartment of Vascular Surgery, St George's University Hospital NHS Foundation Trust, London, UKDepartment of Medicine, Infectious Diseases and Microbiology, Frimley Health NHS Foundation Trust, Berkshire, UKDepartment of Medicine, Infectious Diseases and Microbiology, Frimley Health NHS Foundation Trust, Berkshire, UKDepartment of Medicine, Infectious Diseases and Microbiology, Frimley Health NHS Foundation Trust, Berkshire, UKABSTRACT: Objectives: The long-term outcomes of patients following Gram-negative bacteraemia (GNB) are poorly understood. Here we describe a cohort of patients with GNB over a 2-year period and determine factors associated with late mortality (death between Days 31 and 365 after detection of bacteraemia). Methods: This was a single-centre, retrospective, observational cohort study of 789 patients with confirmed Escherichia coli, Klebsiella spp. or Pseudomonas aeruginosa bacteraemia with a follow-up of 1 year. Multivariable survival analysis was used to determine risk factors for late mortality in patients who survived the initial 30-day period of infection. Results: Overall, 1-year all-cause mortality was 36.2%, with 18.1% of patients dying within 30 days and 18.1% of patients suffering late mortality. An adverse antimicrobial resistance profile [hazard ratio (HR) = 1.095 per any additional antimicrobial category, 95% confidence interval (CI) 1.018–1.178; P = 0.014] and infection with P. aeruginosa (HR = 2.08, 95% CI 1.11–3.88; P = 0.022) were independent predictors of late mortality. Other significant factors included Charlson comorbidity index and length of hospitalisation after the index blood culture. Conclusion: Patients with GNB have a poor long-term prognosis. Risk factors for greater mortality at 1 year include co-morbidity, length of hospitalisation, and infecting organism and its resistance profile.http://www.sciencedirect.com/science/article/pii/S2213716521000862BacteraemiaGram-negative bacteriaMortalityEscherichia coliKlebsiellaPseudomonas aeruginosa |
| spellingShingle | Ioannis Baltas Thomas Stockdale Matija Tausan Areeba Kashif Javeria Anwar Junaid Anvar Eirini Koutoumanou David Sidebottom Veronica Garcia-Arias Melanie Wright Jane Democratis Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study Journal of Global Antimicrobial Resistance Bacteraemia Gram-negative bacteria Mortality Escherichia coli Klebsiella Pseudomonas aeruginosa |
| title | Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study |
| title_full | Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study |
| title_fullStr | Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study |
| title_full_unstemmed | Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study |
| title_short | Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study |
| title_sort | long term outcome and risk factors for late mortality in gram negative bacteraemia a retrospective cohort study |
| topic | Bacteraemia Gram-negative bacteria Mortality Escherichia coli Klebsiella Pseudomonas aeruginosa |
| url | http://www.sciencedirect.com/science/article/pii/S2213716521000862 |
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