Effect on 30-day mortality and duration of hospitalization of empirical antibiotic therapy in CRGNB-infected pneumonia

Annals of Clinical Microbiology and Antimicrobials

Shujin Li¹  Rongrong Li¹  Kunwei Cui²  Jilu Shen³  Hao Tang³  Huaming Xu³ 

[1] Department of Clinical Laboratory, The Second People’s Hospital of Hefei City, Hefei, Anhui Province, China;First Affiliated Hospital of Anhui Medical University Laboratory, Hefei, China;Fourth Affiliated Hospital of Anhui Medical University Laboratory, 230012, Hefei, China;

关键词: Reasonable empirical antibiotics treatment;    Bacterial pneumonia;    Carbapenemase-producing;    Gram-negative bacteria;    Mortality;   

DOI  :  10.1186/s12941-021-00421-2

来源: Springer

【 摘 要 】

BackgroundThe objective of this study was to investigate whether unreasonable empirical antibiotic treatment (UEAT) had an impact on 30-day mortality and duration of hospitalization in bacterial pneumonia caused by carbapenem-resistant gram-negative bacteria (CRGNB).MethodsThis was a retrospective cohort study involving CRGNB-infected pneumonia. All CRGNB-infected pneumonia patients received empirical and targeted antibiotic treatment (TAT), and they were divided into reasonable empirical antibiotic treatment (REAT) and UEAT according to whether the empirical antibiotic treatment (EAT) was reasonable. The data of the two groups were compared to analyze their influence on the 30-day mortality and hospitalization time in CRGNB-infected pneumonia patients. Moreover, we also considered other variables that might be relevant and conducted multivariable regression analysis of 30-day mortality and duration of hospitalization in CRGNB-infected pneumonia patients.ResultsThe study collected 310 CRGNB-infected pneumonia patients, the most common bacterium is Acinetobacter baumannii (211/310 [68%]), the rest were Klebsiella pneumoniae (46/310 [15%]), Pseudomonas aeruginosa and others (53/310 [17%]). Among them, 76/310 (24.5%) patients received REAT. In the analysis of risk factors, dementia, consciousness were risk factors of 30-day mortality, pulmonary disease, hemodynamic support at culture taken day and recent surgery were risk factors for longer hospital stay. The analysis of 30-day mortality showed that UEAT was not associated with 30-day mortality for the 30-day mortality of REAT and UEAT were 9 of 76 (11.84%) and 36 of 234 (15.38%) (P = 0.447), respectively. Meanwhile, there was difference between REAT and UEAT (P = 0.023) in the analysis of EAT on hospitalization time in CRGNB-infected pneumonia patients.ConclusionsUEAT was not associated with 30-day mortality while was related to duration of hospitalization in CRGNB-infected pneumonia patients, in which Acinetobacter baumanniii accouned for the majority.

【 授权许可】

CC BY