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[Enterobacter, Serratia, Acinetobacter or Pseudomonas septicemias]
V Billiau1, C Beuscart, O Leroy
1Service Régional des Maladies Infectieuses, Tourcoing, France.
Abstract:
During 1985 and 1986, 48 bacteremias due to Enterobacter spp, Acinetobacter spp, Serratia spp or Pseudomonas spp were collected by the SES Group. The mortality rate of those infections due to multiresistant organisms appeared high (27.9%). Among all factors influencing the prognosis, the following, age over 75 years, hospital-acquired infections, occurrence of shock and single antimicrobial therapy, are those associated with a high fatality rate. Given that clinical signs are not specific, nosocomial bacteremias should be treated by antimicrobial agents having wide spectrum, rapid onset of action and most often in combination.
Insights
Mortality from bacteremia caused by multidrug-resistant organisms was high (27.9%). Advanced age, hospital-acquired infections, shock, and single-drug therapy increased fatality risk in these severe infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Critical Care Medicine
Context:
- Bacteremia due to Gram-negative bacilli, including Enterobacter, Acinetobacter, Serratia, and Pseudomonas species, poses a significant clinical challenge.
- Multidrug-resistant (MDR) organisms were identified in 48 cases collected between 1985 and 1986.
- A high mortality rate of 27.9% was observed in infections caused by these MDR organisms.
Purpose:
- To analyze the mortality rate and identify prognostic factors associated with bacteremia caused by specific Gram-negative bacilli.
- To guide antimicrobial treatment strategies for nosocomial bacteremias, especially those involving MDR pathogens.
Summary:
- The study identified key factors contributing to a high fatality rate in bacteremic patients.
- Factors associated with increased mortality included advanced age (over 75 years), hospital-acquired infections, septic shock, and the use of single antimicrobial therapy.
- Clinical presentation of these infections is often non-specific, complicating early diagnosis and treatment.
Impact:
- Findings underscore the severity of infections caused by multidrug-resistant Gram-negative bacilli.
- Recommendations emphasize the use of broad-spectrum, rapid-acting antimicrobial agents, often in combination, for treating nosocomial bacteremias.
- Highlights the need for vigilant infection control and timely, appropriate antimicrobial stewardship in healthcare settings.