https://scholars.lib.ntu.edu.tw/handle/123456789/578080
標題: | Influence of severity of infection on the effect of appropriate antimicrobial therapy for Acinetobacter baumannii bacteremic pneumonia | 作者: | Kang F.-Y. How C.-K. Wang Y.-C. ARISTINE CHENG Yang Y.-S. Kuo S.-C. Liu C.-P. Liu Y.-M. Chen T.-L. Lee Y.-T. |
關鍵字: | Acinetobacter baumannii; Appropriate antimicrobial therapy; Bacteremia; Pneumonia; Severity | 公開日期: | 2020 | 出版社: | BioMed Central Ltd | 卷: | 9 | 期: | 1 | 起(迄)頁: | 160 | 來源出版物: | Antimicrobial Resistance and Infection Control | 摘要: | Background: The impact of appropriate antimicrobial therapy for A. baumannii bacteremic pneumonia has not been well established due to the inclusion of the three phenotypically indistinguishable Acinetobacter species and confounding factors including underlying diseases and severity of infection. This retrospective study aimed to evaluate the impact of appropriate antimicrobial therapy on 14-day mortality in A. baumannii bacteremic pneumonia patients after adjusting for risk factors. Methods: This study was conducted at five medical centers in Taiwan between July 2012 and June 2016. A. baumannii species identification was performed using reference molecular methods. Risk factors for 14-day mortality were analyzed via logistic regression. The interaction between the Acute Physiology and Chronic Health Evaluation (APACHE) II score and appropriate antimicrobial therapy was assessed using the logistic model. Results: A total of 336 patients with monomicrobial A. baumannii bacteremic pneumonia were included in this study. The overall 14-day mortality rate was 47.3%. The crude mortality of appropriate antimicrobial therapy was 35.9% (57 of 151 patients). Appropriate antimicrobial therapy was associated with a lower mortality after multivariate adjustment (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.34-0.97; p = 0.04), and the effect was influenced by APACHE II score (OR for interaction term, 0.0098; 95% CI, 0.0005-0.1885; p = 0.002). Further analysis demonstrated that appropriate antimicrobial therapy significantly reduced 14-day mortality among the patients with an APACHE II score > 35 (OR 0.0098; 95% CI 0.0005-0.1885). Conclusion: Appropriate antimicrobial therapy decreases 14-day mortality of the most severely ill patients with A. baumannii bacteremic pneumonia. ? 2020 The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85092271252&doi=10.1186%2fs13756-020-00824-4&partnerID=40&md5=c1b09ababbdc976269ba6d6c9b9e7191 https://scholars.lib.ntu.edu.tw/handle/123456789/578080 |
ISSN: | 2047-2994 | DOI: | 10.1186/s13756-020-00824-4 | SDG/關鍵字: | amikacin; aminoglycoside; carbapenem; carbapenem derivative; cefepime; ceftazidime; cephalosporin derivative; ciprofloxacin; colistin; imipenem; levofloxacin; meropenem; penicillin derivative; piperacillin plus tazobactam; prednisolone; quinoline derived antiinfective agent; sulbactam; sultamicillin; tigecycline; antiinfective agent; Acinetobacter infection; adult; all cause mortality; antimicrobial therapy; APACHE; Article; bacterial pneumonia; blood culture; chronic kidney failure; comorbidity; controlled study; disease severity; drug effect; female; hemodialysis; human; human cell; loading drug dose; logistic regression analysis; major clinical study; male; medical record review; microbiological examination; mortality; multivariate analysis; nonhuman; priority journal; retrospective study; risk factor; species identification; Taiwan; tracheostomy; ventilator associated pneumonia; Acinetobacter baumannii; Acinetobacter infection; aged; bacteremia; clinical trial; drug effect; genetics; isolation and purification; microbiology; mortality; multicenter study; pneumonia; severity of illness index; statistical model; Acinetobacter baumannii; Acinetobacter Infections; Aged; Anti-Bacterial Agents; Bacteremia; Female; Humans; Logistic Models; Male; Mortality; Multivariate Analysis; Pneumonia; Severity of Illness Index |
顯示於: | 醫學系 |
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