Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey.
Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Uludag University, Bursa, Turkey.
J Chemother. 2022 Nov;34(7):436-445. doi: 10.1080/1120009X.2022.2064703. Epub 2022 Apr 21.
This study aimed to evaluate the influencing variables for outcomes in patients with septic shock having culture-proven carbapenem-resistant Gram-negative pathogens. It included 120 patients (mean age 64.29 ± 1.35 years and 58.3% female). The mean Sequential Organ Failure Assessment score during septic shock diagnosis was found to be 11.22 ± 0.43 and 9 ± 0.79 among the patients with mortality and among the survivors, respectively (P = 0.017). The logistic regression analysis showed that empirical treatment as mono Gram-negative bacteria-oriented antibiotic therapy (P = 0.016, odds ratio (OR) = 17.730, 95% confidence interval (CI): 1.728-182.691), Charlson Comorbidity Index >2 (P = 0.032, OR = 7.312, 95% CI: 5.7-18.3), and systemic inflammatory response syndrome score 3 or 4 during septic shock diagnosis (P = 0.014, OR = 5.675, 95% CI: 1.424-22.619) were found as independent risk factors for day 30 mortality. Despite early diagnosis and effective management of patients with septic shock, the mortality rates are quite high in CRGNP-infected patients.
本研究旨在评估患有培养阳性碳青霉烯类耐药革兰氏阴性病原体的脓毒性休克患者结局的影响变量。共纳入 120 例患者（平均年龄 64.29±1.35 岁，58.3%为女性）。脓毒性休克诊断时，患者的序贯器官衰竭评估（SOFA）评分均值为 11.22±0.43，其中死亡患者为 9±0.79，存活患者为 9±0.79（P=0.017）。逻辑回归分析显示，经验性治疗为单革兰氏阴性菌靶向抗生素治疗（P=0.016，比值比（OR）=17.730，95%置信区间（CI）：1.728-182.691）、Charlson 合并症指数>2（P=0.032，OR=7.312，95% CI：5.7-18.3）以及脓毒性休克诊断时全身炎症反应综合征（SIRS）评分 3 或 4（P=0.014，OR=5.675，95% CI：1.424-22.619）是 30 天死亡率的独立危险因素。尽管对脓毒性休克患者进行了早期诊断和有效治疗，但感染 CRGNP 的患者死亡率仍然相当高。
