Nosocomial bacteremia caused by antibiotic-resistant gram-negative bacteria in critically ill patients: clinical outcome and length of hospitalization

Clin Infect Dis. 2002 Jun 15;34(12):1600-6. doi: 10.1086/340616. Epub 2002 May 23.

Abstract

Population characteristics and outcomes were retrospectively compared for critically ill patients with nosocomial bacteremia caused by antibiotic-susceptible (AB-S; n=208) or antibiotic-resistant (AB-R; n=120) gram-negative bacteria. No significant differences in severity of illness and comorbidity factors were seen between groups. Patients with bacteremia caused by AB-R strains had a longer hospitalization before the onset of the bacteremia. The in-hospital mortality for patients with bacteremia caused by AB-S strains was 41.8%; for patients infected with AB-R strains, it was 45.0% (P=.576). A multivariate survival analysis demonstrated that older age (P=.009), a high-risk source of bacteremia (abdominal and lower respiratory tract; P=.031), and a high acute physiology and chronic health evaluation II-related expected mortality (P=.032) were independently associated with in-hospital mortality (P<.05). Antibiotic resistance in nosocomial bacteremia caused by gram-negative bacteria does not adversely affect the outcome for critically ill patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / microbiology*
  • Bacteremia / mortality
  • Cohort Studies
  • Critical Illness
  • Cross Infection / microbiology*
  • Cross Infection / mortality
  • Drug Resistance*
  • Gram-Negative Bacteria
  • Gram-Negative Bacterial Infections / mortality*
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Middle Aged
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Survival Analysis