Article
Treatments and Predictors of Mortality for Carbapenem-Resistant Gram-Negative Bacilli Infections in Malaysia A Retrospective Cohort Study
Author/s | Abubakar, Usman
Zulkarnain, Amni Izzati Rodríguez-Baño, Jesús Kamarudin, Norhidayah Elrggal, Mahmoud E. Elnaem, Mohamed Hassan Harun, Sabariah Noor |
Department | Universidad de Sevilla. Departamento de Medicina |
Publication Date | 2022-12-02 |
Deposit Date | 2023-05-18 |
Published in |
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Abstract | This study evaluated the treatments, mortality rate and patient-related factors associated with mortality. This is a retrospective study involving hospitalised patients with infections caused by carbapenem-resistant ... This study evaluated the treatments, mortality rate and patient-related factors associated with mortality. This is a retrospective study involving hospitalised patients with infections caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) in a tertiary hospital in Malaysia from January 2018 to June 2020. A clinical pharmacist reviewed patients’ electronic records and collected the data according to a pre-designed form. Data were analysed using both descriptive and inferential tests. The study included 145 patients with CR-GNB infections including 77, 40 and 28 Acinetobacter baumannii, enterobacteriaceae and Pseudomonas aeruginosa, respectively. The mean age was 57.9 ± 15.8 years. Pneumonia (40.7%) and bacteremia (25.5%) were the most common infections. Meropenem (24.7%) and piperacillin-tazobactam (20.4%) were the most commonly used empiric antibiotics while colistin (63.3%) and amikacin (8.3%) were the most common definitive antibiotics. The mean duration before active antibiotics was 4.6 ± 3.3 days. Overall, the in-hospital mortality rate was 41.4%. Multivariate logistic regression analysis showed that intensive care unit (ICU) admission (adjusted odds ratio (AOR): 5.201; 95% confidence interval (CI): 1.603–16.872; p = 0.006), sepsis/septic shock (AOR: 3.430; 95% CI: 1.021–11.522; p = 0.049) and elevated serum creatinine (AOR: 2.752; 95% CI: 1.005–7.536; p = 0.049) were independently associated with mortality. The mortality rate among patients with CR-GNB infection is high. A high rate of inappropriate antibiotic use was observed, including combination antibiotic therapy and delays in starting active antibiotics. Mortality was significantly associated with ICU admission, sepsis/septic shock and elevated serum creatinine. |
Funding agencies | Deanship of Scientific Research at Umm Al-Qura University |
Project ID. | 22UQU4320605DSR06 |
Citation | Abubakar, U., Zulkarnain, A.I., Rodríguez-Baño, J., Kamarudin, N., Elrggal, M.E., Elnaem, M.H. y Harun, S.N. (2022). Treatments and Predictors of Mortality for Carbapenem-Resistant Gram-Negative Bacilli Infections in Malaysia A Retrospective Cohort Study. Tropical Medicine and Infectious Disease, 7 (12), 415. https://doi.org/10.3390/tropicalmed7120415. |
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