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Prognostic role of time to positivity of blood culture in children with Pseudomonas aeruginosa bacteremia
- Source :
- BMC Infectious Diseases, BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-10 (2020)
- Publication Year :
- 2019
-
Abstract
- Background Pseudomonas aeruginosa (P. aeruginosa) is a major Gram-negative pathogen, which has been reported to result in high mortality. We aim to investigate the prognostic value and optimum cut-off point of time-to-positivity (TTP) of blood culture in children with P. aeruginosa bacteremia. Methods From August 2014 to November 2018, we enrolled the inpatients with P. aeruginosa bacteremia in a 1500-bed tertiary teaching hospital in Chongqing, China retrospectively. Receiver operating characteristic (ROC) analysis was used to determine the optimum cut-off point of TTP, and logistic regression were employed to explore the risk factors for in-hospital mortality and septic shock. Results Totally, 52 children with P. aeruginosa bacteremia were enrolled. The standard cut-off point of TTP was18 h. Early TTP (≤18 h) group patients had remarkably higher in-hospital mortality (42.9% vs 9.7%, P = 0.014), higher incidence of septic shock (52.4% vs12.9%, P = 0.06), higher Pitt bacteremia scores [3.00 (1.00–5.00) vs 1.00 (1.00–4.00), P = 0.046] and more intensive care unit admission (61.9% vs 22.6%, P = 0.008) when compared with late TTP (> 18 h) groups. Multivariate analysis indicated TTP ≤18 h, Pitt bacteremia scores ≥4 were the independent risk factors for in-hospital mortality (OR 5.88, 95%CI 1.21–21.96, P = 0.035; OR 4.95, 95%CI 1.26–27.50, P = 0.024; respectively). The independent risk factors for septic shock were as follows: TTP ≤18 h, Pitt bacteremia scores ≥4 and hypoalbuminemia (OR 6.30, 95%CI 1.18–33.77, P = 0.032; OR 8.15, 95%CI 1.15–42.43, P = 0.014; OR 6.46, 95% CI 1.19–33.19 P = 0.031; respectively). Conclusions Early TTP (≤18 hours) appeared to be associated with worse outcomes for P. aeruginosa bacteremia children.
- Subjects :
- Male
medicine.medical_specialty
China
Time Factors
Bacteremia
Outcomes
Logistic regression
medicine.disease_cause
law.invention
lcsh:Infectious and parasitic diseases
Tertiary Care Centers
law
Risk Factors
Internal medicine
medicine
Humans
Blood culture
lcsh:RC109-216
Pseudomonas Infections
Hypoalbuminemia
Hospital Mortality
Child
Children
Retrospective Studies
medicine.diagnostic_test
Pseudomonas aeruginosa
business.industry
Septic shock
Incidence (epidemiology)
Time to positivity
Infant
medicine.disease
Prognosis
Intensive care unit
Shock, Septic
Hospitalization
Intensive Care Units
Infectious Diseases
Logistic Models
ROC Curve
Blood Culture
Child, Preschool
Female
business
Research Article
Subjects
Details
- ISSN :
- 14712334
- Volume :
- 20
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC infectious diseases
- Accession number :
- edsair.doi.dedup.....4bc486986f0debd37832a9413ea26ae5