학술논문
Predictors of mortality from extended-spectrum beta-lactamase-producing Enterobacteriaceae bacteremia.
Document Type
Academic Journal
Author
Namikawa H; Department of Medical Education and General Practice, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.; Imoto W; Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.; Yamada K; Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.; Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.; Tochino Y; Department of Medical Education and General Practice, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.; Kaneko Y; Department of Bacteriology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.; Kakeya H; Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.; Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.; Shuto T; Department of Medical Education and General Practice, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Source
Publisher: Taylor & Francis Country of Publication: United States NLM ID: 101594885 Publication Model: Print Cited Medium: Internet ISSN: 2222-1751 (Electronic) Linking ISSN: 22221751 NLM ISO Abbreviation: Emerg Microbes Infect Subsets: MEDLINE
Subject
Language
English
Abstract
ABSTRACT Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) bacteremia can have poor clinical outcomes. Thus, determining the predictors of mortality from ESBL-PE bacteremia is very important. The present systematic review and meta-analysis aimed to evaluate studies to determine predictors associated with ESBL-PE bacteremia mortality. We searched PubMed and Cochrane Library databases for all relevant publications from January 2000 to August 2022. The outcome measure was mortality rate. In this systematic review of 22 observational studies, 4607 patients with ESBL-PE bacteremia were evaluated, of whom 976 (21.2%) died. The meta-analysis showed that prior antimicrobial therapy (RR, 2.89; 95% CI, 1.22-6.85), neutropenia (RR, 5.58; 95% CI, 2.03-15.35), nosocomial infection (RR, 2.46; 95% CI, 1.22-4.95), rapidly fatal underlying disease (RR, 4.21; 95% CI, 2.19-8.08), respiratory tract infection (RR, 2.12; 95% CI, 1.33-3.36), Pitt bacteremia score (PBS) (per1) (RR, 1.35; 95% CI, 1.18-1.53), PBS ≥ 4 (RR, 4.02; 95% CI, 2.77-5.85), severe sepsis (RR, 11.74; 95% CI, 4.68-29.43), and severe sepsis or septic shock (RR, 4.19; 95% CI, 2.83-6.18) were found to be mortality predictors. Moreover, urinary tract infection (RR, 0.15; 95% CI, 0.04-0.57) and appropriate empirical therapy (RR, 0.39; 95% CI, 0.18-0.82) were found to be a protective factor against mortality. Patients with ESBL-PE bacteremia who have the aforementioned require prudent management for improved outcomes. This research will lead to better management and improvement of clinical outcomes of patients with bacteremia caused by ESBL-PE.