Multi-drug-resistant Gram-negative bacterial infection occurred in 32.1% of patients and was associated with significantly higher 30-day and in-hospital mortality compared to non-MDR infection.
Cohort (n=364)
What are the risk factors for multi-drug-resistant Gram-negative bacterial infection and associated 30-day mortality in adult patients following abdominal surgery?
In patients with GNB infection following abdominal surgery, MDR strains are common and associated with worse outcomes, with mortality driven by chronic kidney disease, prior carbapenem use, and inappropriate empirical therapy.
BACKGROUND: Multi-drug-resistant (MDR) Gram-negative bacterial (GNB) infection remains a significant cause of morbidity and mortality among surgical patients. The objective of this study was to recognize the risk factors for MDR GNB infection in patients following abdominal surgery, and determine the predictors independently associated with death. METHODS: From 2010 to 2017, a retrospective cohort study was conducted among patients with abdominal surgery admitted to the surgical intensive care unit (ICU). Patients with GNB infection were included for analyses. RESULTS: In total, 364 patients experienced GNB infection following abdominal surgery. Of these, 117 (32.1%) were MDR GNB infection. Of 133 MDR GNB isolates, the most common isolate was Escherichia coli (45.1%). Patients with MDR GNB infection had significantly longer ventilator-days and hospital stay, as well as higher 30-day and in-hospital mortality compared with non-MDR GNB patients. Multi-variable analysis showed that longer length of pre-ICU stay, surgical re-exploration, receipt of group 2 carbapenems (e.g. imipenem, meropenem and doripenem) and fluoroquinolones, and higher total bilirubin were independent risk factors for the acquisition of MDR GNB infection. Predictors for 30-day mortality among patients with MDR GNB infection were chronic kidney disease, receipt of group 2 carbapenems and inappropriate empirical antimicrobial therapy. CONCLUSIONS: This study provides important information about the risk factors for MDR GNB infection and 30-day mortality among patients following abdominal surgery.
Lin et al. (Fri,) conducted a cohort in Gram-negative bacterial (GNB) infection following abdominal surgery (n=364). Multi-drug-resistant (MDR) Gram-negative bacterial (GNB) infection vs. Non-MDR GNB infection was evaluated on 30-day mortality, in-hospital mortality, ventilator-days, and hospital stay. Multi-drug-resistant Gram-negative bacterial infection occurred in 32.1% of patients and was associated with significantly higher 30-day and in-hospital mortality compared to non-MDR infection.