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Risk factors for mortality in patients with Stenotrophomonas maltophilia bacteremia.

Jeon YD, Jeong WY, Kim MH, Jung IY, Ahn MY, Ann HW, Ahn JY, Han SH, Choi JY, Song YG, Kim JM, Ku NS - Medicine (Baltimore) (2016)

Bottom Line: Stenotrophomonas maltophilia is a nosocomial pathogen associated with high morbidity and mortality, particularly in immunocompromised or critically ill patients.The overall 28-day mortality rate was 36.6%.In the intensive care unit patients, the Acute Physiology and Chronic Health Evaluation II score (P = 0.001) also had significance.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Internal Medicine bAIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Stenotrophomonas maltophilia is a nosocomial pathogen associated with high morbidity and mortality, particularly in immunocompromised or critically ill patients. In this study, we investigated the risk factors for mortality in patients with S. maltophilia bacteremia.Retrospectively, medical records from all patients with S. maltophilia bacteremia between December 2005 and 2014 at Severance Hospital, a 2000-bed tertiary care hospital in Seoul, Korea, were reviewed. Analysis was performed to identify factors associated with 28-day mortality.In total, 142 bacteremia patients were enrolled in this study. The overall 28-day mortality rate was 36.6%. Based on the univariate analysis, hematologic malignancy (P = 0.015), Sepsis-related Organ Failure Assessment (SOFA) score (P < 0.001) and the removal of a central venous catheter (CVC) (P = 0.040) were significantly related to mortality. In the intensive care unit patients, the Acute Physiology and Chronic Health Evaluation II score (P = 0.001) also had significance. Based on the multivariate analysis, the SOFA score (odds ratio [OR] = 1.323; 95% confidence interval [CI]: 1.159, 1.509; P < 0.001) and removal of the CVC (OR = 0.330; 95% CI: 0.109, 0.996; P = 0.049) were independent factors associated with mortality.Our results suggest that removing a CVC may considerably reduce mortality in patients with S. maltophilia bacteremia.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier curve comparing survival between patients with and without the removal of the central venous catheter. ∗CVC = central venous catheter.
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Figure 1: Kaplan–Meier curve comparing survival between patients with and without the removal of the central venous catheter. ∗CVC = central venous catheter.

Mentions: A univariate analysis was performed to identify risk factors associated with 28-day mortality (Table 1). Hematologic malignancy (P = 0.015), SOFA score (P < 0.001), and removal of the CVC (P = 0.040) were significantly related to mortality. In the ICU patients, the APACHE II score (P = 0.001) also had significance. Based on the multivariate analysis, the SOFA score (odds ratio [OR] = 1.323; 95% confidence interval [CI]: 1.159, 1.509; P < 0.001) and removal of the CVC (OR = 0.330; 95% CI: 0.109, 0.996; P = 0.049) were independent factors associated with mortality (Table 2). Hematologic malignancy was not a significant independent factor when combined in the logistic regression model. In addition, a Kaplan–Meier curve was drawn to estimate the impact of CVC removal on survival (Fig. 1). Patients who had the CVC removed had significantly higher survival rates compared to those who did not have the catheter removed (log-rank P = 0.038).


Risk factors for mortality in patients with Stenotrophomonas maltophilia bacteremia.

Jeon YD, Jeong WY, Kim MH, Jung IY, Ahn MY, Ann HW, Ahn JY, Han SH, Choi JY, Song YG, Kim JM, Ku NS - Medicine (Baltimore) (2016)

Kaplan–Meier curve comparing survival between patients with and without the removal of the central venous catheter. ∗CVC = central venous catheter.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979800&req=5

Figure 1: Kaplan–Meier curve comparing survival between patients with and without the removal of the central venous catheter. ∗CVC = central venous catheter.
Mentions: A univariate analysis was performed to identify risk factors associated with 28-day mortality (Table 1). Hematologic malignancy (P = 0.015), SOFA score (P < 0.001), and removal of the CVC (P = 0.040) were significantly related to mortality. In the ICU patients, the APACHE II score (P = 0.001) also had significance. Based on the multivariate analysis, the SOFA score (odds ratio [OR] = 1.323; 95% confidence interval [CI]: 1.159, 1.509; P < 0.001) and removal of the CVC (OR = 0.330; 95% CI: 0.109, 0.996; P = 0.049) were independent factors associated with mortality (Table 2). Hematologic malignancy was not a significant independent factor when combined in the logistic regression model. In addition, a Kaplan–Meier curve was drawn to estimate the impact of CVC removal on survival (Fig. 1). Patients who had the CVC removed had significantly higher survival rates compared to those who did not have the catheter removed (log-rank P = 0.038).

Bottom Line: Stenotrophomonas maltophilia is a nosocomial pathogen associated with high morbidity and mortality, particularly in immunocompromised or critically ill patients.The overall 28-day mortality rate was 36.6%.In the intensive care unit patients, the Acute Physiology and Chronic Health Evaluation II score (P = 0.001) also had significance.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Internal Medicine bAIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Stenotrophomonas maltophilia is a nosocomial pathogen associated with high morbidity and mortality, particularly in immunocompromised or critically ill patients. In this study, we investigated the risk factors for mortality in patients with S. maltophilia bacteremia.Retrospectively, medical records from all patients with S. maltophilia bacteremia between December 2005 and 2014 at Severance Hospital, a 2000-bed tertiary care hospital in Seoul, Korea, were reviewed. Analysis was performed to identify factors associated with 28-day mortality.In total, 142 bacteremia patients were enrolled in this study. The overall 28-day mortality rate was 36.6%. Based on the univariate analysis, hematologic malignancy (P = 0.015), Sepsis-related Organ Failure Assessment (SOFA) score (P < 0.001) and the removal of a central venous catheter (CVC) (P = 0.040) were significantly related to mortality. In the intensive care unit patients, the Acute Physiology and Chronic Health Evaluation II score (P = 0.001) also had significance. Based on the multivariate analysis, the SOFA score (odds ratio [OR] = 1.323; 95% confidence interval [CI]: 1.159, 1.509; P < 0.001) and removal of the CVC (OR = 0.330; 95% CI: 0.109, 0.996; P = 0.049) were independent factors associated with mortality.Our results suggest that removing a CVC may considerably reduce mortality in patients with S. maltophilia bacteremia.

No MeSH data available.


Related in: MedlinePlus