Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2020 |
| Outros Autores: | , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/42840 |
Resumo: | The authors declare that they have no competing interests. |
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Lima, Elisangela M.Cid, Patrícia A.Beck, Debora S.Pinheiro, Luiz Henrique Z.Tonhá, João Pedro S.Alves, Marcio Z. O.Lourenço, Newton D.Santos, Roberto Q.Asensi, Marise D.Marques, José AurélioBandeira, Carolina S.Rodrigues, Caio Augusto S.Gomes Junior, Saint Clair dos SantosGomes, Marisa Z. R.2020-08-19T17:59:56Z2020-08-19T17:59:56Z2020LIMA, Elisangela M. et al. Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study. Antimicrobial Resistance and Infection Control, v. 9, n. 1, p. 1-13, 2020.2047-2994https://www.arca.fiocruz.br/handle/icict/4284010.1186/s13756-020-00791-wThe authors declare that they have no competing interests.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil / Ministério da Saúde. Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil.Ministério da Saúde. Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.Ministério da Saúde. Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.Ministério da Saúde. Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil.Ministério da Saúde. Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil.Ministério da Saúde. Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional da Saúde da Mulher da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Institute Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil / Ministério da Saúde. Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil.Studies have investigated risk factors for infections by specific species of carbapenem-resistant Gram-negative bacilli (CR-GNB), but few considered the group of GNB species and most of them were performed in the setting of bacteremia or hospital infection. This study was implemented to identify risk factors for sepsis by CR- and carbapenem-susceptible (CS) GNB in intensive care unit (ICU) patients to improve management strategies for CR-GNB sepsis. Methods: We developed a case-case-control study from a prospective cohort of patients with systemic inflammatory response syndrome (SIRS), sepsis-2 or sepsis-3 criteria in which blood and other sample cultures were collected and antimicrobial therapy was instituted, in an adult clinical-surgical ICU, at tertiary public hospital in Rio de Janeiro, from August 2015 through March 2017. Results: Among the total of 629 ICU admissions followed by 7797 patient-days, after applying inclusion and exclusion criteria we identified 184 patients who developed recurrent or single hospital-acquired sepsis. More than 90% of all evaluable cases of sepsis and 87% of control group fulfilled the modified sepsis-3 definition. Nonfermenting bacilli and ventilator-associated pneumonia predominated as etiology and source of CR-GNB sepsis. While Enterobacteriaceae and intra-abdominal surgical site plus urinary-tract infections prevailed in CS-GNB than CR-GNB sepsis. Carbapenemase production was estimated in 76% of CR-GNB isolates. Multivariate logistic regression analysis revealed previous infection (mostly hospital-acquired bacterial infection or sepsis) (OR = 4.28; 95% CI 1.77–10.35), mechanical ventilation (OR = 4.21; 95% CI 1.17–15.18), carbapenem use (OR = 3.42; 95% CI 1.37–8.52) and length of hospital stay (OR = 1.03; 95% CI 1.01–1.05) as independent risk factors for sepsis by CR-GNB. While ICU readmission (OR = 6.92; 95% CI 1.72–27.78) and nosocomial diarrhea (OR = 5.32; 95% CI 1.07–26.45) were factors associated with CS-GNB sepsis. Conclusions: The investigation of recurrent and not only bacteremic episodes of sepsis was the differential of this study. The results are in agreement with the basic information in the literature. This may help improve management strategies and future studies on sepsis by CR-GNB.engBMCPredictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleAntimicrobial resistanceGram-negative bacilliHospital infectionPolymerase chain reactionRisk factorsSepsisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/42840/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALdocument(6).pdfdocument(6).pdfapplication/pdf1150637https://www.arca.fiocruz.br/bitstream/icict/42840/2/document%286%29.pdf95d6d10297743e5141d7c3a872664407MD52TEXTdocument(6).pdf.txtdocument(6).pdf.txtExtracted 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| dc.title.pt_BR.fl_str_mv |
Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study |
| title |
Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study |
| spellingShingle |
Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study Lima, Elisangela M. Antimicrobial resistance Gram-negative bacilli Hospital infection Polymerase chain reaction Risk factors Sepsis |
| title_short |
Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study |
| title_full |
Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study |
| title_fullStr |
Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study |
| title_full_unstemmed |
Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study |
| title_sort |
Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study |
| author |
Lima, Elisangela M. |
| author_facet |
Lima, Elisangela M. Cid, Patrícia A. Beck, Debora S. Pinheiro, Luiz Henrique Z. Tonhá, João Pedro S. Alves, Marcio Z. O. Lourenço, Newton D. Santos, Roberto Q. Asensi, Marise D. Marques, José Aurélio Bandeira, Carolina S. Rodrigues, Caio Augusto S. Gomes Junior, Saint Clair dos Santos Gomes, Marisa Z. R. |
| author_role |
author |
| author2 |
Cid, Patrícia A. Beck, Debora S. Pinheiro, Luiz Henrique Z. Tonhá, João Pedro S. Alves, Marcio Z. O. Lourenço, Newton D. Santos, Roberto Q. Asensi, Marise D. Marques, José Aurélio Bandeira, Carolina S. Rodrigues, Caio Augusto S. Gomes Junior, Saint Clair dos Santos Gomes, Marisa Z. R. |
| author2_role |
author author author author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Lima, Elisangela M. Cid, Patrícia A. Beck, Debora S. Pinheiro, Luiz Henrique Z. Tonhá, João Pedro S. Alves, Marcio Z. O. Lourenço, Newton D. Santos, Roberto Q. Asensi, Marise D. Marques, José Aurélio Bandeira, Carolina S. Rodrigues, Caio Augusto S. Gomes Junior, Saint Clair dos Santos Gomes, Marisa Z. R. |
| dc.subject.en.pt_BR.fl_str_mv |
Antimicrobial resistance Gram-negative bacilli Hospital infection Polymerase chain reaction Risk factors Sepsis |
| topic |
Antimicrobial resistance Gram-negative bacilli Hospital infection Polymerase chain reaction Risk factors Sepsis |
| description |
The authors declare that they have no competing interests. |
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2020 |
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2020-08-19T17:59:56Z |
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2020-08-19T17:59:56Z |
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2020 |
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LIMA, Elisangela M. et al. Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study. Antimicrobial Resistance and Infection Control, v. 9, n. 1, p. 1-13, 2020. |
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https://www.arca.fiocruz.br/handle/icict/42840 |
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2047-2994 |
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10.1186/s13756-020-00791-w |
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LIMA, Elisangela M. et al. Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study. Antimicrobial Resistance and Infection Control, v. 9, n. 1, p. 1-13, 2020. 2047-2994 10.1186/s13756-020-00791-w |
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