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Clinical manifestations and prognostic factors of Morganella morganii bacteremia.
- Source :
-
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology [Eur J Clin Microbiol Infect Dis] 2015 Feb; Vol. 34 (2), pp. 231-6. Date of Electronic Publication: 2014 Aug 09. - Publication Year :
- 2015
-
Abstract
- Although Morganella morganii causes a variety of clinical infections, there are limited studies on M. morganii bacteremia after the year 2000. A total of 109 patients with M. morganii bacteremia at a medical center in Taiwan from 2003 to 2012 were studied. Among them, 30.3 % had polymicrobial bacteremia and 75.2 % had community-acquired infection. The most common underlying diseases were hypertension (62.4 %) and diabetes mellitus (38.5 %). The urinary tract (41.3 %) was the major portal of entry, followed by the hepatobiliary tract (27.5 %), skin and soft tissue (21.1 %), and primary bacteremia (10.1 %). Susceptibility testing of M. morganii isolates showed ubiquitous resistance to first-generation cephalosporins and ampicillin-clavulanate; resistance rates to gentamicin, piperacillin-tazobactam, and ciprofloxacin were 30.3 %, 1.8 %, and 10.1 %, respectively. Overall, the 14-day mortality was 14.7 %. Univariate analysis revealed that elevated blood urea nitrogen (BUN) values [p = 0.0137, odds ratio (OR) 5.26], intensive care unit (ICU) admission (p = 0.011, OR 4.4), and higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (p < 0.001, OR 1.62) were significantly associated with mortality. The APACHE II score remained the only significant risk factor for mortality in multivariate analysis (p = 0.0012, OR 1.55). In conclusion, M. morganii bacteremia patients were mostly elderly, with one or more comorbidities. Most of the patients had community-acquired infection via the urinary and hepatobiliary tracts. Furthermore, prognosis can be predicted according to disease severity measured by the APACHE II score.
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Ampicillin pharmacology
Anti-Bacterial Agents pharmacology
Bacteremia microbiology
Bacteremia mortality
Cephalosporins pharmacology
Community-Acquired Infections mortality
Drug Resistance, Bacterial
Enterobacteriaceae Infections microbiology
Enterobacteriaceae Infections mortality
Female
Gentamicins pharmacology
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Morganella morganii drug effects
Penicillanic Acid analogs & derivatives
Penicillanic Acid pharmacology
Piperacillin pharmacology
Piperacillin, Tazobactam Drug Combination
Risk Factors
Taiwan epidemiology
Bacteremia epidemiology
Cross Infection
Enterobacteriaceae Infections epidemiology
Morganella morganii isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1435-4373
- Volume :
- 34
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
- Publication Type :
- Academic Journal
- Accession number :
- 25107625
- Full Text :
- https://doi.org/10.1007/s10096-014-2222-8