Factors associated with mortality in Infections caused by Carbapenem-resistant Enterobacteriaceae
Introduction: There is little information about weigh of factors possibly associated with mortality, in infections caused by Carbapenem-resistant Enterobacteriaceae (CRE) in Latin America. Methodology: A case-controls study nested in a historical cohort was performed including all patients with CRE...
- Autores:
-
Gualtero Trujillo, Sandra Milena
Valderrama Beltran, Sandra Liliana
Valencia, Margarita
Rueda, Diana
Muñoz Velandia, Oscar Mauricio
Ariza, Beatriz
Cortes, Gloria
Salgado, Diana
Porras, Yuly
Niño, Angie
- Tipo de recurso:
- Article of journal
- Fecha de publicación:
- 2020
- Institución:
- Pontificia Universidad Javeriana
- Repositorio:
- Repositorio Universidad Javeriana
- Idioma:
- eng
- OAI Identifier:
- oai:repository.javeriana.edu.co:10554/60178
- Acceso en línea:
- https://jidc.org/index.php/journal/article/view/12267
http://hdl.handle.net/10554/60178
https://doi.org/10.3855/jidc.12267
- Palabra clave:
- Carbapenemase
carbapenem resistance
combination therapy
meropenem MICs
Carbapenemase
carbapenem resistance
combination therapy
meropenem MICs
- Rights
- License
- Atribución-NoComercial 4.0 Internacional
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|
dc.title.spa.fl_str_mv |
Factors associated with mortality in Infections caused by Carbapenem-resistant Enterobacteriaceae |
title |
Factors associated with mortality in Infections caused by Carbapenem-resistant Enterobacteriaceae |
spellingShingle |
Factors associated with mortality in Infections caused by Carbapenem-resistant Enterobacteriaceae Carbapenemase carbapenem resistance combination therapy meropenem MICs Carbapenemase carbapenem resistance combination therapy meropenem MICs |
title_short |
Factors associated with mortality in Infections caused by Carbapenem-resistant Enterobacteriaceae |
title_full |
Factors associated with mortality in Infections caused by Carbapenem-resistant Enterobacteriaceae |
title_fullStr |
Factors associated with mortality in Infections caused by Carbapenem-resistant Enterobacteriaceae |
title_full_unstemmed |
Factors associated with mortality in Infections caused by Carbapenem-resistant Enterobacteriaceae |
title_sort |
Factors associated with mortality in Infections caused by Carbapenem-resistant Enterobacteriaceae |
dc.creator.fl_str_mv |
Gualtero Trujillo, Sandra Milena Valderrama Beltran, Sandra Liliana Valencia, Margarita Rueda, Diana Muñoz Velandia, Oscar Mauricio Ariza, Beatriz Cortes, Gloria Salgado, Diana Porras, Yuly Niño, Angie |
dc.contributor.author.none.fl_str_mv |
Gualtero Trujillo, Sandra Milena Valderrama Beltran, Sandra Liliana Valencia, Margarita Rueda, Diana Muñoz Velandia, Oscar Mauricio Ariza, Beatriz Cortes, Gloria Salgado, Diana Porras, Yuly Niño, Angie |
dc.contributor.corporatename.spa.fl_str_mv |
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Infectología Pontificia Universidad Javeriana. Facultad de Medicina. Hospital Universitario San Ignacio |
dc.contributor.javerianateacher.none.fl_str_mv |
Valderrama Beltran, Sandra Liliana Muñoz Velandia, Oscar Mauricio |
dc.contributor.ascribedclinicalteacher.none.fl_str_mv |
Gualtero Trujillo, Sandra Milena |
dc.subject.spa.fl_str_mv |
Carbapenemase carbapenem resistance combination therapy meropenem MICs |
topic |
Carbapenemase carbapenem resistance combination therapy meropenem MICs Carbapenemase carbapenem resistance combination therapy meropenem MICs |
dc.subject.keyword.spa.fl_str_mv |
Carbapenemase carbapenem resistance combination therapy meropenem MICs |
description |
Introduction: There is little information about weigh of factors possibly associated with mortality, in infections caused by Carbapenem-resistant Enterobacteriaceae (CRE) in Latin America. Methodology: A case-controls study nested in a historical cohort was performed including all patients with CRE infections diagnosed between June 2013 and December 2018 at Hospital Universitario San Ignacio in Bogotá, Colombia. Univariate and multivariate analysis were performed to compare cases of mortality within the first month after the infection diagnosis with surviving patients. Results: A total of 131 patients were included. The overall 30-day mortality rate was 38.17%. In the multivariate analysis, a direct association was found between mortality and septic shock (OR 26.7 CI6.6-107.3 p < 0.01), post-chemotherapy febrile neutropenia (OR 3.3 CI1.06–10.8 p = 0.04) and Charlson Index ≥ 3 (OR 5.5 CI 1.5-20.06 p < 0.01). An inverse association was found with interventions to control the infectious focus (OR 0.3 CI0.1-0.7 p < 0.01). The MIC of different antibiotics and the use of combined antibiotic therapy (triple therapy vs. double therapy or monotherapy) were not associated with mortality. Conclusions: In patients with CRE infections, septic shock, a Charlson comorbidity index ≥ 3, and post-chemotherapy febrile neutropenia are independently related to an increase in mortality. The control of the infectious focus is a protective factor. A rapid identification of these patients, and the implementation of measures to control infectious focus and to detect CRE colonization in patients who are going to be taken to myelosuppressive chemotherapy could impact positively the prognosis of these patients. |
publishDate |
2020 |
dc.date.created.none.fl_str_mv |
2020-06 |
dc.date.accessioned.none.fl_str_mv |
2022-06-06T15:56:12Z |
dc.date.available.none.fl_str_mv |
2022-06-06T15:56:12Z |
dc.type.local.spa.fl_str_mv |
Artículo de revista |
dc.type.coar.spa.fl_str_mv |
http://purl.org/coar/resource_type/c_6501 |
format |
http://purl.org/coar/resource_type/c_6501 |
dc.identifier.spa.fl_str_mv |
https://jidc.org/index.php/journal/article/view/12267 |
dc.identifier.issn.spa.fl_str_mv |
1972-2680 / 2036-6590 |
dc.identifier.uri.none.fl_str_mv |
http://hdl.handle.net/10554/60178 |
dc.identifier.doi.spa.fl_str_mv |
https://doi.org/10.3855/jidc.12267 |
dc.identifier.instname.spa.fl_str_mv |
instname:Pontificia Universidad Javeriana |
dc.identifier.reponame.spa.fl_str_mv |
reponame:Repositorio Institucional - Pontificia Universidad Javeriana |
dc.identifier.repourl.spa.fl_str_mv |
repourl:https://repository.javeriana.edu.co |
url |
https://jidc.org/index.php/journal/article/view/12267 http://hdl.handle.net/10554/60178 https://doi.org/10.3855/jidc.12267 |
identifier_str_mv |
1972-2680 / 2036-6590 instname:Pontificia Universidad Javeriana reponame:Repositorio Institucional - Pontificia Universidad Javeriana repourl:https://repository.javeriana.edu.co |
dc.language.iso.spa.fl_str_mv |
eng |
language |
eng |
dc.relation.citationstartpage.spa.fl_str_mv |
654 |
dc.relation.citationendpage.spa.fl_str_mv |
659 |
dc.relation.ispartofjournal.spa.fl_str_mv |
Journal of Infection in Developing Countries |
dc.relation.citationvolume.spa.fl_str_mv |
14 |
dc.relation.citationissue.spa.fl_str_mv |
6 |
dc.rights.licence.*.fl_str_mv |
Atribución-NoComercial 4.0 Internacional |
dc.rights.uri.*.fl_str_mv |
http://creativecommons.org/licenses/by-nc/4.0/ |
dc.rights.coar.spa.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
rights_invalid_str_mv |
Atribución-NoComercial 4.0 Internacional http://creativecommons.org/licenses/by-nc/4.0/ http://purl.org/coar/access_right/c_abf2 |
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PDF |
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application/pdf |
institution |
Pontificia Universidad Javeriana |
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Atribución-NoComercial 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc/4.0/http://purl.org/coar/access_right/c_abf2Gualtero Trujillo, Sandra MilenaValderrama Beltran, Sandra LilianaValencia, MargaritaRueda, DianaMuñoz Velandia, Oscar MauricioAriza, BeatrizCortes, GloriaSalgado, DianaPorras, YulyNiño, AngiePontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. InfectologíaPontificia Universidad Javeriana. Facultad de Medicina. Hospital Universitario San IgnacioValderrama Beltran, Sandra LilianaMuñoz Velandia, Oscar MauricioGualtero Trujillo, Sandra Milena2022-06-06T15:56:12Z2022-06-06T15:56:12Z2020-06https://jidc.org/index.php/journal/article/view/122671972-2680 / 2036-6590http://hdl.handle.net/10554/60178https://doi.org/10.3855/jidc.12267instname:Pontificia Universidad Javerianareponame:Repositorio Institucional - Pontificia Universidad Javerianarepourl:https://repository.javeriana.edu.coIntroduction: There is little information about weigh of factors possibly associated with mortality, in infections caused by Carbapenem-resistant Enterobacteriaceae (CRE) in Latin America. Methodology: A case-controls study nested in a historical cohort was performed including all patients with CRE infections diagnosed between June 2013 and December 2018 at Hospital Universitario San Ignacio in Bogotá, Colombia. Univariate and multivariate analysis were performed to compare cases of mortality within the first month after the infection diagnosis with surviving patients. Results: A total of 131 patients were included. The overall 30-day mortality rate was 38.17%. In the multivariate analysis, a direct association was found between mortality and septic shock (OR 26.7 CI6.6-107.3 p < 0.01), post-chemotherapy febrile neutropenia (OR 3.3 CI1.06–10.8 p = 0.04) and Charlson Index ≥ 3 (OR 5.5 CI 1.5-20.06 p < 0.01). An inverse association was found with interventions to control the infectious focus (OR 0.3 CI0.1-0.7 p < 0.01). The MIC of different antibiotics and the use of combined antibiotic therapy (triple therapy vs. double therapy or monotherapy) were not associated with mortality. Conclusions: In patients with CRE infections, septic shock, a Charlson comorbidity index ≥ 3, and post-chemotherapy febrile neutropenia are independently related to an increase in mortality. The control of the infectious focus is a protective factor. A rapid identification of these patients, and the implementation of measures to control infectious focus and to detect CRE colonization in patients who are going to be taken to myelosuppressive chemotherapy could impact positively the prognosis of these patients.Q4Q3Introduction: There is little information about weigh of factors possibly associated with mortality, in infections caused by Carbapenem-resistant Enterobacteriaceae (CRE) in Latin America. Methodology: A case-controls study nested in a historical cohort was performed including all patients with CRE infections diagnosed between June 2013 and December 2018 at Hospital Universitario San Ignacio in Bogotá, Colombia. Univariate and multivariate analysis were performed to compare cases of mortality within the first month after the infection diagnosis with surviving patients. Results: A total of 131 patients were included. The overall 30-day mortality rate was 38.17%. In the multivariate analysis, a direct association was found between mortality and septic shock (OR 26.7 CI6.6-107.3 p < 0.01), post-chemotherapy febrile neutropenia (OR 3.3 CI1.06–10.8 p = 0.04) and Charlson Index ≥ 3 (OR 5.5 CI 1.5-20.06 p < 0.01). An inverse association was found with interventions to control the infectious focus (OR 0.3 CI0.1-0.7 p < 0.01). The MIC of different antibiotics and the use of combined antibiotic therapy (triple therapy vs. double therapy or monotherapy) were not associated with mortality. Conclusions: In patients with CRE infections, septic shock, a Charlson comorbidity index ≥ 3, and post-chemotherapy febrile neutropenia are independently related to an increase in mortality. The control of the infectious focus is a protective factor. A rapid identification of these patients, and the implementation of measures to control infectious focus and to detect CRE colonization in patients who are going to be taken to myelosuppressive chemotherapy could impact positively the prognosis of these patients.https://orcid.org/0000-0003-3348-2387Revista Internacional - IndexadaA2SiPDFapplication/pdfengCarbapenemasecarbapenem resistancecombination therapymeropenem MICsCarbapenemasecarbapenem resistancecombination therapymeropenem MICsFactors associated with mortality in Infections caused by Carbapenem-resistant EnterobacteriaceaeArtículo de revistahttp://purl.org/coar/resource_type/c_6501654659Journal of Infection in Developing Countries146ORIGINAL56.pdf56.pdfArtículoapplication/pdf563076http://repository.javeriana.edu.co/bitstream/10554/60178/1/56.pdfef38f058b60033b07e8794d9c781ccbcMD51open accessLICENSElicense.txtlicense.txttext/plain; charset=utf-82603http://repository.javeriana.edu.co/bitstream/10554/60178/2/license.txt2070d280cc89439d983d9eee1b17df53MD52open accessTHUMBNAIL56.pdf.jpg56.pdf.jpgIM Thumbnailimage/jpeg10041http://repository.javeriana.edu.co/bitstream/10554/60178/3/56.pdf.jpg81b9240f365f0e7aee221a4ebc06ccc1MD53open access10554/60178oai:repository.javeriana.edu.co:10554/601782022-06-09 03:04:29.769Repositorio Institucional - Pontificia Universidad Javerianarepositorio@javeriana.edu.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 |