肺炎克雷伯菌引起的重症监护病房获得性肺炎死亡率的危险因素

Sanamed Pub Date : 2023-01-01 DOI:10.5937/sanamed0-46093
Sönmez Ufuk, Derya Çağlayan, Sarp Singil, Gürsel Ersan, Atalay Sabr
{"title":"肺炎克雷伯菌引起的重症监护病房获得性肺炎死亡率的危险因素","authors":"Sönmez Ufuk, Derya Çağlayan, Sarp Singil, Gürsel Ersan, Atalay Sabr","doi":"10.5937/sanamed0-46093","DOIUrl":null,"url":null,"abstract":"Objective: Hospital-acquired pneumonia (HAP) developing in intensive care units (ICU) is an important problem. Gram-negative bacteria are the most important cause of HAP. Among these bacteria, Klebsiella pneumoniae is among the most important pathogens. The mortality rate for infections caused by carbapenem-resistant Klebsiella pneumoniae is high. Identifying mortality risk factors is crucial to prevent potential deaths. The aim of this study was to determine the risk factors associated with mortality in HAP due to Klebsiella pneumoniae in intensive care unit patients. Material and Methods: This cross-sectional study was conducted between 01. May 2021. and 01. May 2023. in the Anesthesia and Reanimation Intensive Care Unit of Izmir Tepecik Training and Research Hospital. Patients aged 18 years who were diagnosed with hospital-acquired pneumonia due to Klebsiella pneumoniae were included in the study. The dependent variable of the study was 14-day mortality due to Klebsiella pneumoniae pneumonia. Independent variables were presence of COVID-19, bacteremia, ceftazidime/avibactam treatment, intubation, sepsis, Charlson comorbidity score, and laboratory parameters. We conducted logistic regression analysis using the backward elimination method to identify independent predictors of mortality. Results: A total of 176 patients were included in the study. The mean age of the patients was 64.6 ± 16.2 years and 64.2% were male. The 14-day mortality rate was 29% (n:51). In the regression analysis performed to determine the risk factors for mortality; in the univariate regression analysis, day 0 leukocyte count > 10.600/mm3 (OR: 2.31; 95% CI: 1.10-4.84), platelet value < 140.000/mm3 (OR: 2.26; 95% CI: 1.06-4.81), AST > 50 U/L (OR: 2.40; 95% CI: 1.20-4.79) and creatinine > 1.3 mg/dL (OR: 1.96; 95% CI: 1.006-3.82) were associated with mortality. In multivariate regression analysis, a leukocyte count > 10.600/mm3 (OR: 2.30; 95% CI: 1.03-5.14) and an AST > 50 U/L (OR: 2.23; 95% CI: 1.04-4.75) were found to be independent predictors of mortality. Conclusion: In conclusion, leukocytosis and high AST levels were found to be independent risk factors associated with mortality in cases of Klebsiella pneumoniae in the intensive care unit. Taking these factors into account, in addition to other parameters and scores that determine the prognosis of patients, may be useful in reducing mortality.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":"36 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk factors for mortality in intensive care unit-acquired pneumonia due to Klebsiella pneumoniae\",\"authors\":\"Sönmez Ufuk, Derya Çağlayan, Sarp Singil, Gürsel Ersan, Atalay Sabr\",\"doi\":\"10.5937/sanamed0-46093\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: Hospital-acquired pneumonia (HAP) developing in intensive care units (ICU) is an important problem. Gram-negative bacteria are the most important cause of HAP. Among these bacteria, Klebsiella pneumoniae is among the most important pathogens. The mortality rate for infections caused by carbapenem-resistant Klebsiella pneumoniae is high. Identifying mortality risk factors is crucial to prevent potential deaths. The aim of this study was to determine the risk factors associated with mortality in HAP due to Klebsiella pneumoniae in intensive care unit patients. Material and Methods: This cross-sectional study was conducted between 01. May 2021. and 01. May 2023. in the Anesthesia and Reanimation Intensive Care Unit of Izmir Tepecik Training and Research Hospital. Patients aged 18 years who were diagnosed with hospital-acquired pneumonia due to Klebsiella pneumoniae were included in the study. The dependent variable of the study was 14-day mortality due to Klebsiella pneumoniae pneumonia. Independent variables were presence of COVID-19, bacteremia, ceftazidime/avibactam treatment, intubation, sepsis, Charlson comorbidity score, and laboratory parameters. We conducted logistic regression analysis using the backward elimination method to identify independent predictors of mortality. Results: A total of 176 patients were included in the study. The mean age of the patients was 64.6 ± 16.2 years and 64.2% were male. The 14-day mortality rate was 29% (n:51). In the regression analysis performed to determine the risk factors for mortality; in the univariate regression analysis, day 0 leukocyte count > 10.600/mm3 (OR: 2.31; 95% CI: 1.10-4.84), platelet value < 140.000/mm3 (OR: 2.26; 95% CI: 1.06-4.81), AST > 50 U/L (OR: 2.40; 95% CI: 1.20-4.79) and creatinine > 1.3 mg/dL (OR: 1.96; 95% CI: 1.006-3.82) were associated with mortality. In multivariate regression analysis, a leukocyte count > 10.600/mm3 (OR: 2.30; 95% CI: 1.03-5.14) and an AST > 50 U/L (OR: 2.23; 95% CI: 1.04-4.75) were found to be independent predictors of mortality. Conclusion: In conclusion, leukocytosis and high AST levels were found to be independent risk factors associated with mortality in cases of Klebsiella pneumoniae in the intensive care unit. Taking these factors into account, in addition to other parameters and scores that determine the prognosis of patients, may be useful in reducing mortality.\",\"PeriodicalId\":53269,\"journal\":{\"name\":\"Sanamed\",\"volume\":\"36 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sanamed\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5937/sanamed0-46093\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sanamed","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5937/sanamed0-46093","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

目的:医院获得性肺炎(Hospital-acquired pneumonia, HAP)是重症监护病房(ICU)的一个重要问题。革兰氏阴性菌是HAP的最主要病因。在这些细菌中,肺炎克雷伯菌是最重要的病原体之一。耐碳青霉烯肺炎克雷伯菌引起的感染死亡率很高。确定死亡风险因素对于预防潜在死亡至关重要。本研究的目的是确定重症监护病房患者肺炎克雷伯菌导致HAP死亡的相关危险因素。材料与方法:本横断面研究于2001年至2009年进行。2021年5月。和01。2023年5月。伊兹密尔Tepecik培训和研究医院麻醉和复苏重症监护病房被诊断为肺炎克雷伯菌引起的医院获得性肺炎的18岁患者被纳入研究。该研究的因变量是肺炎克雷伯菌肺炎导致的14天死亡率。自变量为是否存在COVID-19、菌血症、头孢他啶/阿维巴坦治疗、插管、败血症、Charlson合并症评分和实验室参数。我们使用反向消去法进行逻辑回归分析,以确定死亡率的独立预测因素。结果:共纳入176例患者。患者平均年龄64.6±16.2岁,男性占64.2%。14天死亡率为29%(51例)。在进行回归分析以确定死亡率的危险因素;在单因素回归分析中,第0天白细胞计数>10.600/mm3 (OR: 2.31;95% CI: 1.10-4.84),血小板值<140.000/mm3 (OR: 2.26;95% CI: 1.06-4.81), AST >50 u / l(或:2.40;95% CI: 1.20-4.79)和肌酐>1.3 mg/dL (OR: 1.96;95% CI: 1.006-3.82)与死亡率相关。在多元回归分析中,白细胞计数>10.600/mm3 (OR: 2.30;95% CI: 1.03-5.14)和AST >50 u / l(或:2.23;95% CI: 1.04-4.75)被发现是死亡率的独立预测因子。结论:总之,白细胞增多和高AST水平是重症监护病房肺炎克雷伯菌死亡的独立危险因素。考虑到这些因素,以及决定患者预后的其他参数和评分,可能有助于降低死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk factors for mortality in intensive care unit-acquired pneumonia due to Klebsiella pneumoniae
Objective: Hospital-acquired pneumonia (HAP) developing in intensive care units (ICU) is an important problem. Gram-negative bacteria are the most important cause of HAP. Among these bacteria, Klebsiella pneumoniae is among the most important pathogens. The mortality rate for infections caused by carbapenem-resistant Klebsiella pneumoniae is high. Identifying mortality risk factors is crucial to prevent potential deaths. The aim of this study was to determine the risk factors associated with mortality in HAP due to Klebsiella pneumoniae in intensive care unit patients. Material and Methods: This cross-sectional study was conducted between 01. May 2021. and 01. May 2023. in the Anesthesia and Reanimation Intensive Care Unit of Izmir Tepecik Training and Research Hospital. Patients aged 18 years who were diagnosed with hospital-acquired pneumonia due to Klebsiella pneumoniae were included in the study. The dependent variable of the study was 14-day mortality due to Klebsiella pneumoniae pneumonia. Independent variables were presence of COVID-19, bacteremia, ceftazidime/avibactam treatment, intubation, sepsis, Charlson comorbidity score, and laboratory parameters. We conducted logistic regression analysis using the backward elimination method to identify independent predictors of mortality. Results: A total of 176 patients were included in the study. The mean age of the patients was 64.6 ± 16.2 years and 64.2% were male. The 14-day mortality rate was 29% (n:51). In the regression analysis performed to determine the risk factors for mortality; in the univariate regression analysis, day 0 leukocyte count > 10.600/mm3 (OR: 2.31; 95% CI: 1.10-4.84), platelet value < 140.000/mm3 (OR: 2.26; 95% CI: 1.06-4.81), AST > 50 U/L (OR: 2.40; 95% CI: 1.20-4.79) and creatinine > 1.3 mg/dL (OR: 1.96; 95% CI: 1.006-3.82) were associated with mortality. In multivariate regression analysis, a leukocyte count > 10.600/mm3 (OR: 2.30; 95% CI: 1.03-5.14) and an AST > 50 U/L (OR: 2.23; 95% CI: 1.04-4.75) were found to be independent predictors of mortality. Conclusion: In conclusion, leukocytosis and high AST levels were found to be independent risk factors associated with mortality in cases of Klebsiella pneumoniae in the intensive care unit. Taking these factors into account, in addition to other parameters and scores that determine the prognosis of patients, may be useful in reducing mortality.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
23
审稿时长
8 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信