Impact of Persistent Multidrug-Resistant Gram-Negative Bacteremia on Clinical Outcome and Mortality
The clinical aspects of persistent bacteremia (PB) caused by gram-negative rods (GNRs) in terms of antimicrobial resistance (AMR) and PB clearance status are unclear. This secondary analysis of a retrospective cohort study investigated differences in PB caused by Enterobacterales and glucose non-fer...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-02-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/12/2/313 |
| _version_ | 1797622806921347072 |
|---|---|
| author | Shiori Kitaya Hajime Kanamori Yukio Katori Koichi Tokuda |
| author_facet | Shiori Kitaya Hajime Kanamori Yukio Katori Koichi Tokuda |
| author_sort | Shiori Kitaya |
| collection | DOAJ |
| description | The clinical aspects of persistent bacteremia (PB) caused by gram-negative rods (GNRs) in terms of antimicrobial resistance (AMR) and PB clearance status are unclear. This secondary analysis of a retrospective cohort study investigated differences in PB caused by Enterobacterales and glucose non-fermentative GNRs (NF-GNRs) based on AMR and PB clearance. We retrospectively surveyed medical records at Tohoku University Hospital. Patients for whom blood cultures were performed between January 2012 and December 2021 were recruited. PB cases were grouped based on AMR and PB clearance; the characteristics of PB due to each bacterial pathogen were examined. The main outcome variable was mortality. The late (30–90-day) mortality rate was significantly higher in the multidrug-resistant (MDR) group than in the non-MDR group for Enterobacterales. However, no significant difference was noted in mortality rates between NF-GNRs with and without AMR. Mortality rates tended to be higher in the non-PB-clearance group than in the clearance group for both Enterobacterales and NF-GNRs. Since the mortality rate was higher in the MDR group in the case of Enterobacterales PB, more careful management is necessary for this condition. Follow-up blood cultures and confirming the clearance of PB are useful for improving the survival rate. |
| first_indexed | 2024-03-11T09:15:30Z |
| format | Article |
| id | doaj.art-eb6941f2cbc4462cbea63f3fd3ec072a |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T09:15:30Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-eb6941f2cbc4462cbea63f3fd3ec072a2023-11-16T18:43:14ZengMDPI AGAntibiotics2079-63822023-02-0112231310.3390/antibiotics12020313Impact of Persistent Multidrug-Resistant Gram-Negative Bacteremia on Clinical Outcome and MortalityShiori Kitaya0Hajime Kanamori1Yukio Katori2Koichi Tokuda3Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanThe clinical aspects of persistent bacteremia (PB) caused by gram-negative rods (GNRs) in terms of antimicrobial resistance (AMR) and PB clearance status are unclear. This secondary analysis of a retrospective cohort study investigated differences in PB caused by Enterobacterales and glucose non-fermentative GNRs (NF-GNRs) based on AMR and PB clearance. We retrospectively surveyed medical records at Tohoku University Hospital. Patients for whom blood cultures were performed between January 2012 and December 2021 were recruited. PB cases were grouped based on AMR and PB clearance; the characteristics of PB due to each bacterial pathogen were examined. The main outcome variable was mortality. The late (30–90-day) mortality rate was significantly higher in the multidrug-resistant (MDR) group than in the non-MDR group for Enterobacterales. However, no significant difference was noted in mortality rates between NF-GNRs with and without AMR. Mortality rates tended to be higher in the non-PB-clearance group than in the clearance group for both Enterobacterales and NF-GNRs. Since the mortality rate was higher in the MDR group in the case of Enterobacterales PB, more careful management is necessary for this condition. Follow-up blood cultures and confirming the clearance of PB are useful for improving the survival rate.https://www.mdpi.com/2079-6382/12/2/313persistent bacteremiaEnterobacteralesglucose-nonfermenting gram-negative rodantimicrobial resistancefollow-up blood cultureclearance of persistent bacteremia |
| spellingShingle | Shiori Kitaya Hajime Kanamori Yukio Katori Koichi Tokuda Impact of Persistent Multidrug-Resistant Gram-Negative Bacteremia on Clinical Outcome and Mortality Antibiotics persistent bacteremia Enterobacterales glucose-nonfermenting gram-negative rod antimicrobial resistance follow-up blood culture clearance of persistent bacteremia |
| title | Impact of Persistent Multidrug-Resistant Gram-Negative Bacteremia on Clinical Outcome and Mortality |
| title_full | Impact of Persistent Multidrug-Resistant Gram-Negative Bacteremia on Clinical Outcome and Mortality |
| title_fullStr | Impact of Persistent Multidrug-Resistant Gram-Negative Bacteremia on Clinical Outcome and Mortality |
| title_full_unstemmed | Impact of Persistent Multidrug-Resistant Gram-Negative Bacteremia on Clinical Outcome and Mortality |
| title_short | Impact of Persistent Multidrug-Resistant Gram-Negative Bacteremia on Clinical Outcome and Mortality |
| title_sort | impact of persistent multidrug resistant gram negative bacteremia on clinical outcome and mortality |
| topic | persistent bacteremia Enterobacterales glucose-nonfermenting gram-negative rod antimicrobial resistance follow-up blood culture clearance of persistent bacteremia |
| url | https://www.mdpi.com/2079-6382/12/2/313 |
| work_keys_str_mv | AT shiorikitaya impactofpersistentmultidrugresistantgramnegativebacteremiaonclinicaloutcomeandmortality AT hajimekanamori impactofpersistentmultidrugresistantgramnegativebacteremiaonclinicaloutcomeandmortality AT yukiokatori impactofpersistentmultidrugresistantgramnegativebacteremiaonclinicaloutcomeandmortality AT koichitokuda impactofpersistentmultidrugresistantgramnegativebacteremiaonclinicaloutcomeandmortality |