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Association between mortality and highly antimicrobial-resistant bacteria in intensive care unit-acquired pneumonia.
- Source :
-
Scientific reports [Sci Rep] 2021 Aug 13; Vol. 11 (1), pp. 16497. Date of Electronic Publication: 2021 Aug 13. - Publication Year :
- 2021
-
Abstract
- Data on the relationship between antimicrobial resistance and mortality remain scarce, and this relationship needs to be investigated in intensive care units (ICUs). The aim of this study was to compare the ICU mortality rates between patients with ICU-acquired pneumonia due to highly antimicrobial-resistant (HAMR) bacteria and those with ICU-acquired pneumonia due to non-HAMR bacteria. We conducted a multicenter, retrospective cohort study using the French National Surveillance Network for Healthcare Associated Infection in ICUs ("REA-Raisin") database, gathering data from 200 ICUs from January 2007 to December 2016. We assessed all adult patients who were hospitalized for at least 48 h and presented with ICU-acquired pneumonia caused by S. aureus, Enterobacteriaceae, P. aeruginosa, or A. baumannii. The association between pneumonia caused by HAMR bacteria and ICU mortality was analyzed using the whole sample and using a 1:2 matched sample. Among the 18,497 patients with at least one documented case of ICU-acquired pneumonia caused by S. aureus, Enterobacteriaceae, P. aeruginosa, or A. baumannii, 3081 (16.4%) had HAMR bacteria. The HAMR group was associated with increased ICU mortality (40.3% vs. 30%, odds ratio (OR) 95%, CI 1.57 [1.45-1.70], P < 0.001). This association was confirmed in the matched sample (3006 HAMR and 5640 non-HAMR, OR 95%, CI 1.39 [1.27-1.52], P < 0.001) and after adjusting for confounding factors (OR ranged from 1.34 to 1.39, all P < 0.001). Our findings suggest that ICU-acquired pneumonia due to HAMR bacteria is associated with an increased ICU mortality rate, ICU length of stay, and mechanical ventilation duration.<br /> (© 2021. The Author(s).)
- Subjects :
- Acinetobacter Infections drug therapy
Acinetobacter Infections microbiology
Acinetobacter Infections mortality
Age Factors
Aged
Drug Resistance, Bacterial
Enterobacteriaceae Infections drug therapy
Enterobacteriaceae Infections microbiology
Enterobacteriaceae Infections mortality
Female
Healthcare-Associated Pneumonia drug therapy
Healthcare-Associated Pneumonia microbiology
Humans
Male
Middle Aged
Pneumonia, Bacterial drug therapy
Pneumonia, Bacterial microbiology
Pneumonia, Staphylococcal drug therapy
Pneumonia, Staphylococcal microbiology
Pneumonia, Staphylococcal mortality
Prohibitins
Pseudomonas Infections drug therapy
Pseudomonas Infections microbiology
Pseudomonas Infections mortality
Retrospective Studies
Risk Factors
Sex Factors
Healthcare-Associated Pneumonia mortality
Intensive Care Units statistics & numerical data
Pneumonia, Bacterial mortality
Subjects
Details
- Language :
- English
- ISSN :
- 2045-2322
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scientific reports
- Publication Type :
- Academic Journal
- Accession number :
- 34389761
- Full Text :
- https://doi.org/10.1038/s41598-021-95852-4