Predictors of mortality in patients with Gram-Negative Bacilli (GNB) blood stream infections (BSI): multicentre data from India.

BACKGROUND

This study was done with objectives of determining the predictors of mortality in patients with Gram-Negative Bacilli (GNB) Blood stream Infection (BSI) along with estimating mortality attributable to carbapenem resistance (CR).

METHODS

In this prospective cohort study (January 2023-September 2024), done in 3 tertiary care centres in India, patients found to have mono-microbial GNB BSI were included. Primary outcome was crude mortality at day 30 of onset of BSI.

RESULTS

Out of 604 patients, mortality at day 30 happened in 140 (23.2%) patients. Intergroup analysis between patients alive ( = 464) and dead ( = 140) at day 30 revealed that lower age ( = 0.014), higher Sequential Organ Failure Assessment Score (SOFA) score ( < 0.001), higher Pitts Bacteraemia score ( < 0.001), acquisition of BSI in hospital ( = 0.003) and CR in & [CRKP] and (CRAB) and DTR (defined as non-susceptibility to carbapenems, β-lactam-β-lactamase inhibitor combinations, and fluoroquinolones) in [DTR-PA] (CR ,  = 0.034; CRKP,  = 0.012; CRAB,  < 0.001; DTR-PA,  < 0.001) was associated with higher mortality. On multivariate logistic regression analysis, higher SOFA score ( < 0.001) and BSI due to DTR-PA ( = .006) and CRAB (= .017) were found to be independent predictors of mortality. Attributable mortality of CR in and and DTR in PA was 7.32, 8.43 and 52.4% respectively.

CONCLUSION

We did not find CR as a major contributing factor for death among patients with BSI due to in our study cohort.