Mortality and Length of Stay in Patients with Bloodstream Infections Due to Drug-Susceptible Versus Drug-Resistant Gram-Negative Bacteria
International Journal of Infectious Diseases and Therapy
Volume 4, Issue 3, September 2019, Pages: 33-39
Received: Jul. 26, 2019; Accepted: Aug. 20, 2019; Published: Sep. 6, 2019
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Authors
Jamal Wadi Al Ramahi, Department of Medicine, School of Medicine, University of Jordan, Amman, Jordan
Ahmad Al-Abdouh, Department of Internal Medicine, Al Takhassusi Hospital, Amman, Jordan
Nour Hasan, Department of Pharmacy, Al Khalidi Hospital, Amman, Jordan
Ghayda Haddad, Department of Pharmacy, Al Khalidi Hospital, Amman, Jordan
Mohammad Al Baba, Department of Internal Medicine, Al Takhassusi Hospital, Amman, Jordan
Ahmad Al Aaraj, Department of Internal Medicine, Al Takhassusi Hospital, Amman, Jordan
Mahmoud Fakhri, Department of Medicine, Jordan Hospital, Amman, Jordan
Lamya Abu Shanab, Department of Pharmacy, Jordan Hospital, Amman, Jordan
Belal Harara, Department of Intensive Care Unit, Al Khalidi Hospital, Amman, Jordan
Mahmoud Barbarawi, Department of Internal Medicine, Al Takhassusi Hospital, Amman, Jordan
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Abstract
A prospective patient surveillance and analysis in three urban hospitals with the objective of comparing the mortality rates among patients with antimicrobials-sensitive versus -resistant gram-negative bacterial bloodstream infections. The analysis focused on the rates of in-hospital and 28-days mortality. There were 189 patients with BSI, drug-susceptible gram-negative bacteria (DSGNB) 40.7%, multi-drug resistant bacteria (MDRGNB) 42.3% and extensive-drug resistant bacteria (XDRGNB) 16.9%. The mean age, gender, SOFA score on the initial evaluation, APACHE II score, comorbidities, identified bacterial species, and BSI-associated diagnoses were not statistically different except for VAP (P = 0.000) in the XDRGNB infected patients. In-hospital and 28-days mortalities were significantly higher in the XDRGNB-BSI group (P = 0.000), and ICU length of stay (P = 0.000). XDRGNB-BSI was significantly higher in inappropriate and delayed treated patients (P < 0.05). Logistic regression analysis demonstrated no significant interaction for the 28 days mortality neither with the admission diagnoses, the antimicrobial class (except aminoglycosides), the comorbidities (except for solid tumors) (P > 0.05, Nagelkerke R2 < 0.4). In conclusion, BSI due to multiple class antimicrobial resistance has higher mortality and ICU length of stay.
Keywords
Multidrug-resistant Bacteria, Extensive Drug-resistant Bacteria, Bloodstream Infection, Appropriate Therapy, ICU Length of Stay
To cite this article
Jamal Wadi Al Ramahi, Ahmad Al-Abdouh, Nour Hasan, Ghayda Haddad, Mohammad Al Baba, Ahmad Al Aaraj, Mahmoud Fakhri, Lamya Abu Shanab, Belal Harara, Mahmoud Barbarawi, Mortality and Length of Stay in Patients with Bloodstream Infections Due to Drug-Susceptible Versus Drug-Resistant Gram-Negative Bacteria, International Journal of Infectious Diseases and Therapy. Vol. 4, No. 3, 2019, pp. 33-39. doi: 10.11648/j.ijidt.20190403.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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