Inappropriate empirical antimicrobial treatment in bloodstream infections patients in the era of multidrug resistance

• Autor(a) principal: Urzedo, Jane Eire
• Data de Publicação: 2022
• Outros Autores: Menezes, Ralciane de Paula, Ferreira, Melina Lorraine, de Brito, Cristiane Silveira, Dantas, Raquel Cristina Cavalcanti, Gontijo Filho, Paulo Pinto, Ribas, Rosineide Marques
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista de Epidemiologia e Controle de Infecção
• Texto Completo: https://online.unisc.br/seer/index.php/epidemiologia/article/view/16855
• topic: Pseudomonas aeruginosa; Carbapenem; bloodstream infection; mortality

Background and objectives: Bloodstream infection (BSI) by multidrug-resistant Pseudomonas aeruginosa is a severe infection. This study aimed to evaluate and identify the predictors of mortality in patients who had bloodstream infection by carbapenem-resistant P. aeruginosa. Methods: This is a retrospective cohort study, approved by Committee of Ethics in Research with Human Participants, which included 87 consecutive patients hospitalized in a referral hospital in Brazil. Clinical and demographic information about each patient were obtained from hospital records. The Student’s T-test was used to compare continuous variables and x2 or Fisher’s exact tests to compare categorical variables. To determine independent risk factors for 30-day mortality, a multiple logistic regression model was used. A survival curve was constructed using the Kaplan–Meier method. Results: Among the patients, 87.3% use antibiotics previously, 60.9% received inadequate empirical treatment, and the 30-day mortality rate was 57.5%. Inappropriate antibiotic empirical therapy was independently associated with a 30-days death and mortality rate. Conclusion: These findings can show some insights about the relationship between higher mortality and inappropriate empirical therapy for patients with BSI by P. aeruginosa. There is a need for better diagnostic tests and infection control programs should focus on de-escalation the antibiotic inappropriate therapy, mainly in BSI caused by carbapenem-resistant P. aeruginosa.