Predicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care units

Detalhes bibliográficos
Autor(a) principal: Dantas, L. F.
Data de Publicação: 2019
Outros Autores: Dalmas, B., Andrade, R. M., Hamacher, S., Bozza, F. A.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/36065
Resumo: 2020-10-02
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spelling Dantas, L. F.Dalmas, B.Andrade, R. M.Hamacher, S.Bozza, F. A.2019-10-02T13:39:09Z2019-10-02T13:39:09Z2019DANTAS, L. F. et al. Predicting acquisition of carbapenem-resistant gram-negative pathogens in intensive care units. Journal of Hospital Infection, v. 103, p. 121-127, 2019.0195-6701https://www.arca.fiocruz.br/handle/icict/3606510.1016/j.jhin.2019.04.0131532-2939engElsevierPredicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care unitsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2020-10-02Pontifical Catholic University of Rio de Janeiro. Industrial Engineering Department. Rio de Janeiro, RJ, Brazil.Université Clermont Auvergne. Clermont-Ferrand, France / École de Mines Saint-Etienne. CNRS. UMR 6158 LIMOS. Centre CIS. Saint-Etienne, France.Copa D’Or Hospital. Rio de Janeiro, RJ, Brazil / Federal University of the State of Rio de Janeiro. Department of General Medicine. Rio de Janeiro, RJ, Brazil.Pontifical Catholic University of Rio de Janeiro. Industrial Engineering Department. Rio de Janeiro, RJ, Brazil.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Background: Infections by multidrug-resistant Gram-negative (MDRGN) bacteria are among the greatest contemporary health concerns, especially in intensive care units (ICUs), and may be associated with increased hospitalization time, morbidity, costs, and mortality. Aim: The study aimed to predict carbapenem-resistant MDRGN acquisition in ICUs, to determine its risk factors, and to assess the impact of this acquisition on mortality rate. Methods: A matched caseecontrol study was performed in patients admitted to the ICU at a large Brazilian hospital over a five-year period. Cases were defined as patients who acquired carbapenem-resistant MDRGN bacteria during hospitalization. Controls were defined as patients who had no detection of carbapenem-resistant MDRGN bacteria. Cases were matched to controls according to the admission period. Risk factors were identified by multiple logistic regression using a stepwise selection method. Findings: In total, 343 cases and 1029 controls were analysed. The 30-day mortality rate for subjects with ICU-associated carbapenem-resistant MDRGN was 37.6%. Five variables were identified as statistically significant and more relevant for the acquisition of multidrug-resistant strains: increased Simplified Acute Physiology Score 3, patients with severe chronic obstructive pulmonary disease and exposure to haemodialysis catheter, central venous catheter, or mechanical ventilation. Models developed displayed good results with an accuracy of w90%. Patients who acquired MDRGN were 2.72 times more likely to die than non-MDRGN acquisition patients. Conclusion: Finding risk factors and developing predictive models may benefit patients through early detection and by controlling the spread of MDR. The presence of mechanical ventilation and central venous catheter were the main risk factors demonstrated, and their use requires special attention.Carbapenem resistanceMulti-drug resistanceGram-negativeHealthcare-associated infectionPredictive modelsIntensive care unitsinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83104https://www.arca.fiocruz.br/bitstream/icict/36065/1/license.txt79178e5f2a0eb066867a274556814938MD51ORIGINALve_Dantas_L_etal_INI_2019.pdfve_Dantas_L_etal_INI_2019.pdfapplication/pdf369311https://www.arca.fiocruz.br/bitstream/icict/36065/2/ve_Dantas_L_etal_INI_2019.pdf72528325dd33f85506cc953858a3caa4MD52TEXTve_Dantas_L_etal_INI_2019.pdf.txtve_Dantas_L_etal_INI_2019.pdf.txtExtracted 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dc.title.pt_BR.fl_str_mv Predicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care units
title Predicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care units
spellingShingle Predicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care units
Dantas, L. F.
Carbapenem resistance
Multi-drug resistance
Gram-negative
Healthcare-associated infection
Predictive models
Intensive care units
title_short Predicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care units
title_full Predicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care units
title_fullStr Predicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care units
title_full_unstemmed Predicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care units
title_sort Predicting acquisition of carbapenem-resistant Gram-negative pathogens in intensive care units
author Dantas, L. F.
author_facet Dantas, L. F.
Dalmas, B.
Andrade, R. M.
Hamacher, S.
Bozza, F. A.
author_role author
author2 Dalmas, B.
Andrade, R. M.
Hamacher, S.
Bozza, F. A.
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Dantas, L. F.
Dalmas, B.
Andrade, R. M.
Hamacher, S.
Bozza, F. A.
dc.subject.en.pt_BR.fl_str_mv Carbapenem resistance
Multi-drug resistance
Gram-negative
Healthcare-associated infection
Predictive models
Intensive care units
topic Carbapenem resistance
Multi-drug resistance
Gram-negative
Healthcare-associated infection
Predictive models
Intensive care units
description 2020-10-02
publishDate 2019
dc.date.accessioned.fl_str_mv 2019-10-02T13:39:09Z
dc.date.available.fl_str_mv 2019-10-02T13:39:09Z
dc.date.issued.fl_str_mv 2019
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv DANTAS, L. F. et al. Predicting acquisition of carbapenem-resistant gram-negative pathogens in intensive care units. Journal of Hospital Infection, v. 103, p. 121-127, 2019.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/36065
dc.identifier.issn.pt_BR.fl_str_mv 0195-6701
dc.identifier.doi.none.fl_str_mv 10.1016/j.jhin.2019.04.013
dc.identifier.eissn.none.fl_str_mv 1532-2939
identifier_str_mv DANTAS, L. F. et al. Predicting acquisition of carbapenem-resistant gram-negative pathogens in intensive care units. Journal of Hospital Infection, v. 103, p. 121-127, 2019.
0195-6701
10.1016/j.jhin.2019.04.013
1532-2939
url https://www.arca.fiocruz.br/handle/icict/36065
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/36065/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/36065/2/ve_Dantas_L_etal_INI_2019.pdf
https://www.arca.fiocruz.br/bitstream/icict/36065/3/ve_Dantas_L_etal_INI_2019.pdf.txt
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