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Shift in risk factors for mortality by period of the bloodstream infection timeline

Authors
 Min Hyuk Choi  ;  Dokyun Kim  ;  Jihyun Kim  ;  Young Goo Song  ;  Seok Hoon Jeong 
Citation
 JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION, Vol.57(1) : 97-106, 2024-02 
Journal Title
JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION
ISSN
 1684-1182 
Issue Date
2024-02
MeSH
Bacteremia* / microbiology ; Escherichia coli ; Humans ; Retrospective Studies ; Risk Factors ; Sepsis* / complications ; Vancomycin-Resistant Enterococci*
Abstract
Background: This study was designed to determine changes in risk factors on the prognosis of patients during each period of the bloodstream infection (BSI) timeline.

Methods: Through an integrated study of multivariable regressions with machine learning techniques, the risk factors for mortality during each period of BSI were analyzed.



Results: A total of 302,303 inpatients who underwent blood cultures during 2011-2021 were enrolled. More than 8 % of BSI cases progressed to subsequent BSI, and risk factors were identified as gut colonization with vancomycin-resistant enterococci (aOR 1.82; 95 % CI 1.47-2.24), intensive care unit admission (aOR 3.37; 95 % CI 3.35-4.28), and current cancer chemotherapy (aOR 1.54; 95 % CI 1.36-1.74). The mean SOFA score of the deceased patients during the first 7 days was 10.6 (SD 4.3), which was significantly higher than those on days 8-30 (7.0 ± 4.2) and after Day 30 (4.0 ± 3.5). BSIs caused by Acinetobacter baumannii and Candida albicans were more likely to result in deaths of patients for all time periods (all, P < 0.001). BSIs caused by Enterococcus faecalis and Enterococcus faecium were associated with a poor outcome in the period after Day 30 (both, P < 0.001). Nonsusceptible phenotypes to β-lactam/β-lactamase inhibitors of Escherichia coli and Klebsiella pneumoniae influenced the prognoses of patients with BSI in terms of high mortality rates during both days 8-30 and after Day 30.

Conclusion: Influence of microbiological factors on mortality, including BSI-causative microorganisms and their major antimicrobial resistance, was emphasized in both periods of days 8-30 and after Day 30.
Files in This Item:
T202401321.pdf Download
DOI
10.1016/j.jmii.2023.11.008
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dokyun(김도균) ORCID logo https://orcid.org/0000-0002-0348-5440
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
Choi, Min Hyuk(최민혁) ORCID logo https://orcid.org/0000-0001-9801-9874
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198683
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