Baltas, I;
Stockdale, T;
Tausan, M;
Kashif, A;
Anwar, J;
Anvar, J;
Koutoumanou, E;
... Democratis, J; + view all
(2021)
Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study.
Journal of Global Antimicrobial Resistance
, 25
pp. 187-192.
10.1016/j.jgar.2021.03.019.
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Abstract
OBJECTIVES: The long-term outcomes of patients following Gram-negative bacteraemia (GNB) are poorly understood. We describe a cohort of patients with GNB over a two-year period and determine factors associated with late mortality (death between days 31 and 365 after detection of bacteraemia). METHODS: This is a single center retrospective observational cohort study of 789 patients with confirmed Escherichia coli, Klebsiella spp and Pseudomonas aeruginosa bacteraemias with a follow-up of one year. Multivariable survival analysis was used to determine the risk factors for late mortality in patients who survived the initial 30-day period of infection. RESULTS: Overall, one-year all-cause mortality was 36.2%, with 18.1% of patients dying within 30 days and 18.1% of patients suffering late mortality. An adverse antimicrobial resistance profile (HR 1.095 per any additional antimicrobial category, 95% CI 1.018 - 1.178, p = 0.014) and infection with Pseudomonas aeruginosa (HR 2.08, 95% CI 1.11 - 3.88, p = 0.022) were independent predictors of late mortality. Other significant factors included the Charlson Comorbidity Index and hospitalization length after the index blood culture. CONCLUSION: Patients with GNB have a poor long-term prognosis. Risk factors for greater mortality at one year include comorbidity, hospitalization length, the infecting organism, and its resistance profile.
| Type: | Article |
|---|---|
| Title: | Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study |
| Location: | Netherlands |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jgar.2021.03.019 |
| Publisher version: | https://doi.org/10.1016/j.jgar.2021.03.019 |
| Language: | English |
| Additional information: | This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
| Keywords: | Adult, Escherichia coli, Klebsiella, Pseudomonas aeruginosa, anti-bacterial agents, bacteremia, gram-negative bacteria, mortality |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10126525 |
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