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Mortality and gram-negative rod bacteraemia in the intensive care unit
D F Gardiner1, S J Scholand, T Babinchak
1Division of International Medicine and Infectious Diseases, Weill Medical College of Cornell University, New York, NY 10021, USA. dfgardiner@gmail.com
Abstract:
This study identified 37 intensive care unit (ICU) patients with gram-negative rod (GNR) bacteraemia. The sources, causative organisms and mortality of gram-negative bacteraemia were consistent with historical series. Antibiotic resistance among well-described species with a propensity for antimicrobial resistance was the most common reason for ineffective antibiotic administration. This study emphasizes the importance of antibiotic resistance in antimicrobial selection and the power of Acute Physiology and Chronic Health Evaluation criteria for predicting patient mortality.
Insights
This study examined 37 intensive care unit patients with gram-negative rod bacteraemia. Antibiotic resistance was a key factor in treatment failure, highlighting its importance in antimicrobial selection.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Clinical Microbiology
Background:
- Gram-negative rod (GNR) bacteraemia is a significant cause of morbidity and mortality in intensive care units (ICUs).
- Understanding the epidemiology, sources, and antimicrobial resistance patterns of GNR bacteraemia is crucial for effective patient management.
Purpose of the Study:
- To identify the sources, causative organisms, and mortality associated with GNR bacteraemia in ICU patients.
- To investigate the impact of antibiotic resistance on treatment outcomes.
- To evaluate the utility of the Acute Physiology and Chronic Health Evaluation (APACHE) criteria in predicting mortality.
Main Methods:
- Retrospective analysis of 37 ICU patients diagnosed with GNR bacteraemia.
- Identification of causative GNR species and their antibiotic susceptibility profiles.
- Assessment of patient mortality and correlation with clinical severity scores (APACHE).
Main Results:
- The epidemiological characteristics and mortality rates of GNR bacteraemia were consistent with previous reports.
- Antimicrobial resistance was identified as the primary reason for ineffective antibiotic therapy in many cases.
- APACHE criteria demonstrated predictive power for patient mortality.
Conclusions:
- Antibiotic resistance significantly impacts the efficacy of antimicrobial treatment for GNR bacteraemia.
- Careful antimicrobial selection, considering resistance patterns, is essential for improving patient outcomes.
- APACHE scoring is a valuable tool for prognostication in critically ill patients with GNR bacteraemia.
